Health Care in the African American Community

Transcription

Health Care in the
African American
Community
Breast Cancer:
Guest Editorial by Maimah Karmo:
Breast Cancer & Young Women (page 3)
PLUS:
Prevention (page 4)
Risks (page 6)
Screening (page 8)
Cervical Cancer (page 9)
Children’s health issues:
Hypertension (page 10)
Infant Mortality (page 12)
Vaccine Debate (page 13)
Childhood Trauma (page 14)
Babies & Breastfeeding (page 15)
Also featuring:
Million Hearts Initiative (page 16)
The Air We Breathe (page 17)
Prostate Screening (page 18)
nbna nurse leadership:
(See pages 20 - 27)
THE NBNA NEWS IS THE OFFICIAL PUBLICATION OF THE NATIONAL BLACK NURSES ASSOCIATION
SPRING 2012
in this issue
President Speaks................................................................................................. 1
GUEST EDITORIAL:
Young Women and Breast Cancer............................................................... 3
NBNA NEWS
The NBNA News is printed quarterly; please
contact the National Office for publication dates.
Breast Cancer Prevention............................................................................. 4
NBNA News
8630 Fenton Street, Suite 330
Silver Spring, MD 20910
www.NBNA.org
Know Your Cancer Risk................................................................................ 6
Ronnie Ursin, DNP, RN, NEA-BC
Editor-in-Chief
Breast Cancer Screening Deterrents........................................................... 8
Cervical Cancer Vaccines............................................................................. 9
The Silent Killer in African American Children........................................... 10
African American Infant Mortality............................................................... 12
The Anti-Vaccine Movement....................................................................... 13
Childhood Trauma....................................................................................... 14
Babies are Born to Breastfeed................................................................... 15
Health Care Perspectives: Women & Children
The Million Hearts Initiative............................................................................... 16
The Air We Breathe............................................................................................ 17
Prostate Screening............................................................................................ 18
Opposing Cuts to Medicaid.............................................................................. 19
Recruiting The Next Generation........................................................................ 19
NBNA Leadership
Prescription Drug Abuse Epidemic............................................................ 20
A Look at Practical Nursing........................................................................ 21
NBNA Strategic Plan................................................................................... 22
Are You a Leader?...................................................................................... 23
Embracing the Challenge of Nursing......................................................... 24
A Helping Hand........................................................................................... 25
Raise the Voice!.......................................................................................... 26
Parliamentary Tidbits.................................................................................. 27
Members On The Move............................................................................... 28-39
Chapter Websites.............................................................................................. 40
Chapter Presidents............................................................................................ 42
NBNA Newsletter
NBNA Newsletter Criteria for Submitting Articles:
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500-750 Word Article
Title of Article, Author’s Name and Credentials (Alison Brown, MSN, RN)
Three-line biographical sketch & author’s headshot photograph (high res)
Resources where appropriate
Send all articles, member news, chapter highlights, pictures, and other
information to [email protected].
Deadline: August 10
NBNA National Office Staff
Millicent Gorham, HD, MBA, FAAN
Executive Director and Associate Editor
Estella Lazenby
Administrative Assistant
Frederick George Thomas
Administrative Assistant
Dianne Mance
Conference Services Coordinator
BOARD OF DIRECTORS:
Deidre Walton, JD, MSN, RN
President, Phoenix, AZ
Betsy L. Harris, MSN, RN
1st Vice President, Atlanta, GA
Lola Denise Jefferson, BSN, RN, CVRN
2nd Vice President Houston, TX
Irene Daniels-Lewis, DNSc, RN, APN, FAAN
Treasurer, Redwood City, CA
Veronica Clarke-Tasker, PhD, MBA, MPH, RN
Secretary, Mitchellville, MD
Debra A. Toney, PhD, RN, FAAN
Immediate Past President, Las Vegas, NV
Ronnie Ursin, DNP, RN, NEA-BC
Parliamentarian, Frederick, MD
Birthale Archie, MSN, BS, RN
Historian, Kentwood, MI
Lauranne Sams, PhD, RN*
Founder, President Emeritus, Tuskegee, AL
Patty Palmer, LVN
Student Representative, Enigma, GA
Keneshia Bryant, PhD, RN, FNP-BC
Little Rock, AR
Barbara Crosby, MPA, BSN, RN-BC
Baltimore, MD
Martha Dawson, DNP, RN, FACHE
Birmingham, AL
Audwin Fletcher, PhD, APRN, FNP-BC, FAAN
Jackson, MS
C. Alicia Georges, EdD, RN, FAAN
Ex-Officio, Bronx, NY
Deborah Jones, MS, RN-C
Texas City, TX
Marcia A. Lowe, MSN, RN
Birmingham, AL
Linda Mitchell, BSN, RN
Honolulu, HI
Rhonda E. Ruben, BAAS, LVN
Beaumont, TX
Ora D. Williams, MHCA, BSN, RN
Atlanta, GA
*Deceased
Dr. Deidre Walton, President
National Black Nurses Association
The Politics of Health Care:
The Role and Responsibility of Nursing
I
n March 2010, President Barack Obama signed into law the Patient Protection and
Affordable Care Act (PPACA), providing the United States the opportunity to transform its health
care system. Nurses can and should play a fundamental role in this transformation (Institute of
Medicine, 2010). The 2010 Affordable Care Act also gives nurses new opportunities to deliver
care and play an integral role in leading change (Hassmiller, 2010). As an advocate for change
and improving the quality of health care in our communities, the National Black Nurses Association (NBNA) focuses on five guiding principles: accessible health care; affordable health care;
endorsements of nursing best practice models; development of ethnic minority nurse leaders in
areas of health policy, practice, education, and research; and, the promotion of the professional
and educational advancement of ethnic minority nurses in the workforce.
The nursing profession is the largest segment of the nation’s health care workforce. Working
on the front lines of patient care, nurses can play a vital role in helping realize the objectives set
forth in the 2010 Affordable Care Act. The Institute of Medicine’s (IOM) report on the Future of
Nursing details recommendations for an action-oriented blue-print for the future of nursing (Institute of Medicine, 2010). In leading the transformation, the NBNA deems it essential to be committed to its mission of eliminating health care disparities and has established an Ad Hoc Committee
on the Future of Nursing. In their commitment to transforming the nursing profession, NBNA
members are taking leadership roles in preparing our communities for the marketplace in the
post-health care reform era. The IOM’s report will help this nation prepare professional licensed
nurses to assume leadership roles at the hospital, in the boardroom, and within the political arena.
Mary K. Wakefield, PhD, RN, HRSA Administrator (Wakefield, 2011) has stated that a well
educated, highly skilled, and diverse nurse workforce is critical to meeting future health care
needs. Rita Wray, chair of the NBNA’s Ad Hoc Committee on the Future of Nursing, plans to
determine further the NBNA’s goals by advancing its organizational impact. The NBNA plans to
increase the proportion of nurses with baccalaureate degrees from 50% to 80% by 2020 and
establish relationships with universities in order to encourage and offer ways for NBNA members
to achieve academic progression. The committee also plans to formulate steps to make an impact
in leadership such as representation on the State Action Coalitions (Walton, 2011). In addition, the
NBNA is taking an active role in the diversity agenda as it relates to the future of nursing to ensure
a workforce that will deliver culturally and linguistically appropriate services.
As it continues to evolve, the Affordable Care Act will open new doors and become a catalyst
for change in our health care delivery system. And, as advocates for change, nurses across this
nation must join forces and contribute to the transformation in health care delivery by preparing
future nurses to meet the needs of our communities, improve the quality of care, and prepare a
high quality, diverse workforce.
References
Hassmiller, S. (2010). Nursing’s Role in Health Care Reform. American Nurse Today, 5(9).
Institute of Medicine. (2010). The Future of Nursing: Leading Change, Advancing Health. Washington, DC:
Institute of Medicine of the National Academies.
Wakefield, M. (2011, July 29). U.S. Department of Health and Human Services. Retrieved from: http://www.
hhs.gov/news/press/2011pres/07/20110729a.html
Walton, D. (2011, December). President. The NBNA: What We Have Accomplished and Where We Are
Headed. Washington, DC, US: National Black Nurses Association, Inc.
Guest Editorial
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Guest Editorial
Young Women and Breast Cancer
NBNA.org — 3
Maimah Karmo
W
hen we embark on this journey called life, one
never knows the twists and turns that fate or destiny
will bring. I had life all planned out, until I heard the
words, “you have breast cancer.” Those words threw me into
a tailspin.
I remember my mother teaching me to do my breast selfexams at thirteen years old. She told me to do them every
month and she told me that if I did, when a change occurred,
I would know. Her words echoed in my head as I stood in the
shower 18 years later and felt a lump in my chest. I went to
see my doctor, who referred me to a breast surgeon. She performed an unsuccessful aspiration then told me that I was too
young to get breast cancer and to “Come back in six months.”
Six months later when the lump had doubled in size, I again
went to see the doctor. I insisted on a biopsy, against the doctor’s wishes. The next day, she called. I had breast cancer. The
day was February 28, 2006. The time was 4:45pm, I immediately got a new doctor.
I later found out that I had stage II, triple negative breast
cancer. If I had waited six months, I may have been facing a
death sentence. My biggest concern was for my 3-year-old
daughter. During my second round of treatment, Tigerlily Foundation was born. I knew the mission had to be something that
would impact younger women.
Younger women generally do not consider themselves to
be at risk for breast cancer, as research shows that women
aged 40 or below comprise approximately 5% (roughly 11,000
cases per year) of all new breast cancer diagnoses (American
Cancer Society, 2006). However, while breast cancer is not
common in young women, young women share an inordinate
amount of the burden—from being diagnosed at a time in their
lives when they least expect it, to receiving more aggressive,
more toxic therapy and experiencing unique psychosocial and
medical effects including potential loss of menses and fertility.
Complicating this is the fact that diagnosing breast cancer in
younger women is more difficult because their breast tissue is
generally more dense than the breast tissue in older women,
early warning signs are ignored and some health care providers dismiss breast lumps in young women as cysts and adopt
a “wait and see” approach.
Breast cancer in younger women may be aggressive and
less likely to respond to treatment. This population experiences
greater effects of the disease and/or treatment on menopausal
symptoms, fertility and family planning, genetic risk, role functioning at home and/or work, beauty and attractiveness and
sexual functioning (Ganz, et al, 2003). Some of these factors can
at times prevent young women from pursuing (timely) screening,
treatment and follow up. Ganz also found that distress among
young women with breast cancer may be further compounded
by the lack of provider awareness (patients may miss opportunities for intervention), information, and resources to address
young women’s issues and the lack of peer support. All of these
dangers lead to gaps in care. Tigerlily fills this gap. We offer education, peer support, buddy bags, meals, financial assistance,
and support for those with stage 4 breast cancer.
In 2009, I met Representative
Debbie Wasserman Schultz. After
sharing my story, she asked to meet
again. Within days, we were in her
office, with my 6 year old running
around her desk, the Breast Cancer
Education and Awareness Requires Learning Young (EARLY)
Act was born. Her office engaged breast organizations nationwide and within a year, the legislation was passed, as part of
the Patient Protection and Affordable Care Act. The EARLY
Act called for a public health campaign to teach young women
that breast cancer can and does occur in young women,
and to help them establish healthy breast habits to follow as
they mature; an education campaign to increase awareness
among providers that breast cancer occurs in young women;
and support services for young women with breast cancer. As
part of the legislation, the Centers for Disease Control (CDC)
was required to develop initiatives to “increase knowledge of
breast health and breast cancer among women, particularly
among those under the age of 40 and those at heightened
risk for developing the disease” (www.cdc.gov). The legislation
also called for a Federal Advisory Committee, which works to
assist CDC in developing evidence-based approaches to advance understanding and awareness of breast cancer among
young women through prevention research, public and health
professional education and awareness activities, and emerging prevention strategies. It has been my honor to have served
on the committee. I often think my life since diagnosis. I never
would have imagined a life better than this, where every day, I can help others. I’d love for you to join Tigerlily in our mission.
Visit www.tigerlilyfoundation.org for more information or email
[email protected].
References
American Cancer Society (2006). Breast cancer facts and figures
2005-2006. Atlanta. American Cancer Society, Inc.
Cleveland Clinic. (2012). Diseases and condition: Breast cancer in young
women. Retrieved June 30, 2012, from http://my.clevelandclinic.org/
disorders/breast_cancer/hic_breast_cancer_in_young_women.
aspx
Ganz et al. (2003). Breast cancer in younger women: Reproductive
and late health effects of treatment. Journal of Clinical Oncology, 21,
4184-93. Retrieved June 30, 2012, from http://jco.ascopubs.org/
content/21/22/4184.full.pdf
Maimah Karmo is the Founder of Tigerlily Foundation and
a three year survivor of breast cancer, who most recently received the Congressional Black Caucus Leadership in Advocacy Award for her work with young women and breast cancer. In
October 2011, Maimah was appointed to the Federal Advisory
Committee on Breast Cancer in Young Women, a committee
established by the Affordable Care Act, on which she will work
to develop initiatives to increase knowledge of breast health
and breast cancer, particularly among women under the age
of 40 and those at heightened risk for developing the disease.
4 — NBNA.org
Women & Children’s Health Issues
Breast Cancer Prevention for African American Women:
The Role of the Advanced Practice Nurse (APN) or Doctor of Nursing Practice (DNP)
Deborah Robinson, DNP, RN, Miami Dade College, School of Nursing
Marie O. Etienne, DNP, ARNP, PLNC, Miami Dade College, Medical Campus
Patricia R. Messmer, PhD, RN-BC, FAAN, Miami Dade College, Medical Campus
Guerna Blot, ARNP-BC, MSN, MBA/HCM, OCN, Mount Sinai Medical Center
G
iger (2011) reports that African American women
have a higher mortality for breast cancer than other
racial and ethnic groups. Of African Americans, 119.9
per 100,000 women develop breast cancer per year, compared to 127.3 per 100,000 Caucasian women (http://seer.
cancer.gov). However, mortality is higher, 32 per 100,000 African American women die of this disease each year, compared
to 22.8 Caucasian per 100,000. Furthermore, the 5-year breast
cancer survival rate is 77% for African American women,
compared to 90.4% for Caucasian (http://seer.cancer.gov).
Although African American women are less likely to get breast
cancer than their Caucasian counterparts, they are more likely
to die from the disease, partially due to access of health care
and mammogram screening.
The American Cancer Society (ACS) in 2012 recommended women aged 40+ receive annual mammogram and clinical
breast examinations; women 20-39 years need clinical breast
examinations every three years. A screening MRI is recommended along with annual mammograms at age 30 for high
risk women. In 2003, the American Cancer Society ceased
recommending all women perform monthly breast self-exams
(BSE) since research demonstrated BSE offered little additional
advantage over heightened breast awareness. ACS recommends health care providers informing women about BSE potential benefits and limitations. The focus of breast cancer
screening is not articulated well in the Black community. There
is a complex web of deleterious factors, including racism in
the health care system, lack of insurance, distrust of the white
medical establishment, and high daily stress levels. “Race and
class differences affect the type of care patients receive...the
darker a women’s skin and/or the lower place in the economic
scale, the poorer the care and efforts at explanation she gets’’
(Thistlewaite, 2003) When African American women are diagnosed with breast cancer, there are multi-facet factors operating in the complicated mechanisms that must be viewed in a
much larger perspective.
For decades, lower survival rates were assumed to be due
primarily to societal issues; African American women were less
likely to have health insurance for mammograms, detecting
early and highly treatable cancers. Historically, research focused on the biological differences between cancers attacking
women of color. African American women are more likely to be
diagnosed at an earlier age but less likely to be diagnosed with
smaller tumors and more likely to be diagnosed with larger and
Dr. Deborah B. Robinson
Dr. Marie O. Etienne
not pictured:
Dr. Patricia, R. Messmer
Guerna Blot, MSN, RN
more aggressive tumors, making treatment problematic (http://
seer.cancer.gov).
Cultural beliefs shape African American women’s ideas and
decisions about breast cancer and screening. For example,
screening practices can be seen as “heralds of disease” that
bring death, whereas faith in God is one if the few benign yet
powerful therapies available (Ashing-Giwa et al, 2004). The importance of alternatives therapies and cultural views on cancer
can affect breast cancer screening among African American
women. According to the National Health Interview survey, the
percentage of women 40+ years of age having a mammogram
within the past two years increased form 29% in 1987 to 70%
in 2000. Because breast cancer mortality rates are higher in
African American women they must be encouraged to have
early screening to reduce late-stage cancer diagnosis and
mortality (ACS, 2012).
CONTINUED ON PAGE 5
prevention continued from page 4
The role of the Advanced Practice Nurse (APN) or the
Doctor of Nursing Practice (DNP) provides opportunities to
design breast cancer prevention programs targeting the African
American community while addressing research questions:
n Since African American women have an earlier onset of
breast cancer, does mammography screening at a younger
age decrease mortality rates?
n What new breast screening methodologies are beneficial to
African American women?
n What is the percentage of BRCA 1 and BRCA 2 gene occurrence in African American women?
When African American women experience breast cancer
symptoms, they should initiate diagnostic testing rather than
adopt a “wait and see” attitude. The Advanced Practice Nurse
or the DNP must foster the advocacy of sisterhood of African
American women in encouraging each other to seek help
when breast cancer symptoms are discovered. Women must
be assertive and provide a coordinated plan of care based on
evidence-based practice. APN s or DNPs must ensure that
African American women receive comprehensive, holistic and
timely care, focusing on primary prevention by:
n Providing health care services (breast cancer screening
and educational programs on Triple Touch II methods).
n Referring clients to a primary care provider and/or Nurse
Practitioners for further assessment.
n Consulting social services for patient financial information
and eligibility in governmental programs.
n Dissemination of breast cancer awareness, anti-smoking
media campaigns, and lifestyle changes in the media.
n Providing clinical and psychological support to clients/families diagnosed with breast cancer.
n Developing alliances with ministers/church groups to sponsor breast cancer prevention, screening clinics and support
groups, capturing cultural aspects.
APNs and DNPs should lobby for state/national policies
promoting breast cancer awareness in African American communities. APNs and DNPs must promote interdisciplinary collaboration, decreasing health care disparities, and foster health
care quality standards.
NBNA.org — 5
References
American Cancer Society. Breast Cancer Facts & Figures 2011-2012.
America Cancer Society, Inc. Atlanta,Georgia.
Ashing-Giwa, K., Padilla,G., Tejero, J., Kraemer, J., Wright, K., Coscararelli, A., Clayton., Williams, I., Hills, D. (2004). Understanding the
breast cancer expereince of women: a qualitative study of African
American, Asian American, Latina and Carucasian cancer survirosr.
Psycho-Oncology 13, 408-428.
Consedine, N. M. (2004). Fear, anxiety, worry and breast cancer
screening behavior. Cancer Epidemiology Biomakers & Prevention
13 , 501-510.
Giger, J.N. (2011). How African Americans fare with susceptibility to
disease: forty years after the founding of the NBNA. The Journal of
the National Black Nurses Association. 22(1), vii-viii
Giger, J.N. & Davidhizer, R (2008). Transcultural nursing: assessment
and intervention (5th ed.) St Louis: Mosby Elsevier.
Thistlewaite, S.B. (2003). The ‘Case” of breast cancer Adam, Eve, and
the Genome (p. 165-166). Minneapolis: Fortress Press.
Surveillance epidemiology and end results retrieved from http:seer.
cancer.gov/statfacts/html/breat.html
Dr. Marie O. Etienne is a professor at Miami Dade College (MDC), Medical Campus, School of Nursing and the 2007
recipient of the MDC Stanley G. Tate and Family Endowed
Teaching Chair for Excellence in Academia.
Dr. Patricia R. Messmer is a consultant for Nursing Education & Research at Miami Dade College, chair of the Nurses
Charitable Trust, serves on the ANA Nominating Committee,
was past ANF trustee/treasurer and ANA-PAC trustee/secretary. Dr. Messmer received the 2009 ANA Jessie Scott Award
and conducted a historical study of ANF scholars (1955-2011).
Dr. Messmer facilitated funding of the ANF Elizabeth Carnegie
grant to support minority nurses conducting research studies.
Dr. Deborah B. Robinson is currently an assistant professor in the RN-BSN Program at Miami Dade College School of
Nursing. She is a graduate in 2009 as a member of the inaugural class of University of Miami Doctorate of Nursing Practice.
In 1993, she received her MBA with a concentration in Health
Administration for the University of Miami School of Business.
She obtained her BSN in 1975 from the Indiana University
School of Nursing.
Guerna Blot, MSN, RN, began her nursing career at
Mount Sinai Medical Center in 1989 in the oncology unit,
where she is currently the Nurse Director of the unit. Her nursing experience encompasses many areas including oncology
nursing, telemetry and medical surgical. She is very active and
well known in the South Florida community through the Haitian
American Nurses Association of Florida (HANA).
6 — NBNA.org
Know Your Cancer Risk: A Daughter’s Story
Veronica Clarke-Tasker, PhD, MBA, MPH, RN
Lelena Gebremariam, SN
Rev. Dr. Veronica A. Clarke-Tasker
W
hen a woman finds a lump in her breast, it can be
a very frightening experience. Usually the first thought
or question that comes to mind as they wish the lump
away is, “is this breast cancer?” I know because I’ve been
there four times since my 31st birthday in 1979. The shock and
disbelief can be unbearable. As nurses, we are expected to
remain calm, supportive and empathic as we encourage ourselves, our patients and our loved ones to seek medical attention. We are also expected to educate women along with their
family about their cancer risks and be their advocate. As many
of you know from your own personal experience with breast
cancer, sometime knowledge about a disease can keep us
from acting positive. What happens when the person you are
to be supportive of is your Mom? I had to be there for Mommy
who knew I was an oncology clinical specialist, yet didn’t want
me to know about her rapidly growing breast mass. I also had
to be there for one of my dearest friends who called me late
one evening and said I want the truth, what are my chances
of surviving breast cancer? You see, her sister had undergone
a mastectomy for breast cancer just five years earlier. Yes, my
colleagues, it is a big responsibility but it must be done.
Breast Cancer Risk factors
The Washington Post has provided testimony and much
needed information about breast cancer particularly in the
African American community (The Washington Post, March
21, 2012 and April 10, 2012). One of the most valuable tools
we can equip our family and public with is accurate information about breast cancer and their breast cancer risks. Yes, it
is true we still do not know the exact cause of breast cancer.
However, we do know what factors may increase an individual’s risk for developing this disease. A more complete list
of breast cancer risk factors can be found in Table 1 below.
(ACS, 2011)
Race and ethnicity: In 2011, the American Cancer Society estimated 26,840 African American women would be
diagnosed with breast cancer making it the most commonly
diagnosed cancer in African American women. In addition,
their prognosis of dying from the disease, an estimated 6,040
of those diagnosed, is greater than any other racial group.
Factors contributing to poor prognosis include distal stage of
disease, higher tumor grade, and having a negative hormone
receptor status.
Age: Although African American women have a lower risk
of developing breast cancer they have a higher risk for developing the disease before the age of 45. It is believed that 1 out of
8 invasive breast can found in younger women.
Genetic risk factors: Inherited mutation BRACA1 and
BRCA2 are the most common cause of hereditary breast
cancer. It is highly recommended that women speak to a genetic counselor before seeking genetic screening. Talking with
a trained professional that can interpret results along with what
the test can and cannot tell you may reduce the stress and
answer questions that many people have about genetic testing. Table 1 is the US Preventive Services Task Force’s recommendations for genetic testing for BRCA mutations.
Family history of breast cancer: A women’s risk for developing breast cancer doubles if the relative was their mother,
sister, or daughter. The risk increases 3 fold if breast cancer is
diagnosed in a 2nd degree relative. Having a father or brother
diagnosed with breast cancer may also increase her risk.
Table 1: US Preventive Services Task Force recommendations for genetic testing for BRCA mutations:
n Two first-degree relatives (mother, sisters, daughters) with
breast cancer, one of whom was diagnosed when they
were younger than 50
n Three or more first- or second-degree relatives (includes
grandmothers, aunts) diagnosed with breast cancer
n Both breast and ovarian cancer among first- and seconddegree relatives
n A first-degree relative diagnosed with cancer in both breasts
n Two or more first- or second-degree relatives diagnosed
with ovarian cancer
n A male relative with breast cancer
n A first-degree relative with breast or ovarian cancer
n Two second-degree relatives on the same side of the family
with breast or ovarian cancer
Source: Adapted from Breast Cancer Facts & Figures 2011-2012, p 13
Table 2: Factors That Increase the Risk for Breast Cancer
in Women; Relative Risk Factor
n Age (65+ vs. <65 years, although risk increases across all
ages until age 80)
n Biopsy-confirmed atypical hyperplasia
n Certain inherited genetic mutations for breast cancer
(BRCA1 and/or BRCA2)
n Mammographically dense breasts
n Personal history of breast cancer
n High endogenous estrogen or testosterone levels
n High bone density (postmenopausal)
n High-dose radiation to chest
n Two first-degree relatives with breast cancer
n Alcohol consumption
n Ashkenazi Jewish heritage
n Early menarche (<12 years)
CONTINUED ON PAGE 7
know your risk continued from page 6
n
n
n
n
n
n
n
n
n
n
n
Height (tall)
High socioeconomic status
Late age at first full-term pregnancy (>30 years)
Late menopause (>55 years)
Never breastfed a child
No full-term pregnancies
Obesity (postmenopausal)/adult weight gain
One first-degree relative with breast cancer
Personal history of endometrium, ovary, or colon cancer
Recent and long-term use of menopausal hormone therapy
containing estrogen and progestin
Recent oral contraceptive use
Source: Breast Cancer Facts & Figures 2011-2012, p. 12
My Story
It was May 1985 and I just returned from an oncology nursing workshop when I received a call from my younger sister.
Quietly she told me, “Mommy found a lump in her breast but
said not to tell you.” Needless to say, I couldn’t believe what I was hearing. I remember that day like it was yesterday down to
the color top she wore and the room we were standing in when
she arrived home. When she saw me she looked at me as she
put her bags down and said, “I see your sisters can’t keep
their mouths shut.” She knew they were going to tell me and
maybe that’s why she told them. As she removed her blouse, I just stood still. I saw the lump before she pointed it out to me.
Mommy had large hanging breast and the lump was the size
of a small lemon. I just couldn’t believe what I was seeing. Can
you imagine how hard it was to remain calm when the women
who birth you, stands before you with a large breast lump and
didn’t tell you when she first found it? I felt like a failure and trust
me my three sisters made sure they reinforced those feelings.
Mommy agreed to see the surgical oncologist I worked
with the next day. I cried all night feeling guilty, and hating the
strong possibly that Mommy had breast cancer. On top of that,
how were my grandmother and the rest of the girls going to
handle the possibility of Mommy having cancer? Dr. R and I had worked together for over 6 years. He was a very supportive and caring physician who had asked me to join his team.
I loved what I did as an oncology nurse, but that day in June
1985 was different. I had to be the supportive daughter with
too much knowledge about cancer. After her clinical breast
examination and mammography Mommy agreed to a one step
surgical procedure. She consented to have a right modified
radical mastectomy. I tried to encourage her to have a two-step
procedure where she would get the diagnosis from the biopsy
and then make her decision. But Mommy being Mommy opted
to have her breast removed if the tissue biopsy during surgery
was positive. In addition, she wanted to have reconstructive
breast surgery.
My grandmother and I accompanied Mommy to the hospital on June 13, 1985. If any of you know me, I could not sit
still. I prayed and tried to not appear frightened as I held my
grandmothers hand. When Dr. R came into the waiting room
his face said it all. Not only was the diagnoses positive but she
had a very aggressive rare cancer known as cystosarcoma
phyllodes. I knew that the next couple of months would be hard
but I had to be strong. Within a year Mommy had successfully
NBNA.org — 7
undergone radiation and chemotherapy as prescribed along
with reconstructive breast surgery. When the cancer returned
one year later it was even more aggressive and she was encouraged to undergo additional treatment. Mommy was in the
hospital receiving chemotherapy Memorial Day weekend, 1987
when she asked me to call the family together for our usual
celebration. I got permission to bring her home for the day. I knew as she tried to stand on her own that this may be the
last time she would see all her family together. I tried to get the
family to come the week before to the Tumor Board as Dr. R
had asked Mommy’s permission to present her case. I, along
with my colleagues at the hospital, knew the severity of her
cancer and how important it was for others to learn from this
case. As my aunt and uncle stood by my side during the tumor
board, I knew her time here on earth was very short. None of
my sisters would come because they didn’t believe Mommy
was dying of breast cancer.
On June 13, 1987, exactly two years after being diagnosed,
and in her own bed at home, Mommy quietly went home to
be with the Lord. My daughter walked into her bedroom at 6
a.m. and thought her grandmother was sleeping, as she had a
smile on her face. However, when she touched her she knew
Mommy had passed. Although the pain was great, and I did not
agree with all the decisions Mommy made about discontinuing
her treatments, I was at peace. My colleagues helped me to be
the supportive daughter and not the caregiver. For two years
my sisters did not speak with me because they felt I should
have made Mommy continue therapy. No, I said, the best thing
you can do is join me in the clinical trial that I had enter which
may prevent us from getting breast cancer. For you see all of us
have fibrocystic disease of the breast just like Mommy and are
at high risk for developing breast cancer.
I successfully completed five years in the Star Clinical trial
in November, 2011. During this double-blind clinical trial, I later
learned I was taking Tamoxifen. Although I gained weight, I was
thankful. I was at high risk for developing breast cancer and I did something about it.
In closing, if you or anyone in your family has not followed the
recommendation for breast cancer screening, start now. If you
don’t know your breast cancer risks talk with your nurse practitioner or physician. My sisters and cousins are now having yearly
mammograms. Lastly, talk to your family about breast cancer
and teach them the correct way to examine their breast.
In Loving Memory of Doris Mae McLeod and Sadie Brown-Hicks
References
American Cancer Society (2012). Cancer facts and figures. Atlanta,
GA: Author
American Cancer Society (2011). Cancer facts and figures for African
Americans, Atlanta, GA: Author
American Cancer Society (2011). Breast Cancer: Early Detection, Atlanta, GA: Author
Williams, Vanessa: Black Women in America: Fighting fear as well as
disease. The Washington Post, Wednesday, March 21 2012, A1.
Rev. Dr. Veronica A. Clarke-Tasker, is a Professor in the
Division of Nursing at Howard University College of Nursing &
Allied Health Sciences, Washington, DC. She is also the Secretary for the National Black Nurses Association.
8 — NBNA.org
Exploring Deterrents to Breast Cancer Screening
in African American Women
Charlotte M. Wood, PhD(c), MSN, MBA, RN
Joan Tilghman, PhD, CNE
B
reast Cancer is a health condition that has
relevance for all races; however it is a particularly
significant issue for African American women. African American women make up greater than 20 million of
our country’s entire population and have been identified as a
target population with pronounced breast cancer disparities
(United States Census Bureau, 2010; Phillips & Cohen, 2011).
There are a host of reasons why African American women are
at greater risk. Behavioral risk factors are primary and include
a sedentary life style, diets high in fat, and a lack of dietary
fiber (Kelley, 2011). Given the circumstances, it is vitally important that community engagement be addressed to impact
the deterrents to breast cancer screening, and early detection
initiatives needed for the prevention of breast cancer.
In 2012, approximately 577,190 Americans are expected
to die of cancer, accounting for more than 1,500 people a day.
Cancer is the second most common cause of death in the
US, exceeded only by heart disease, accounting for nearly 1
out of every 4 deaths (ACS, 2011). An estimated 226,870 new
cases of invasive breast cancer are expected to occur among
women in the United States (US) during 2012; about 2,190
new cases are expected in men. Excluding cancers of the
skin, breast cancer is the most universally diagnosed cancer
in women and the second leading cause of cancer death in
women (Ravert & Huffaker, 2010).
The mortality rate for African American women is 32 out of
100,000, the highest rate among all ethnic groups reported in
the United States. Although, breast cancer survival rates are
at approximately 77% for African American women, the overall
survival can be as high as 97% (Kelley, 2011).
Deterrents to Breast Cancer screening
It has been reported that one of the primary deterrents to
breast cancer screening for African American women is the
fear of cancer (Kelley, 2011). However, the lack of health insurance and other financial barriers prevent many African American women from receiving optimal health care. The National
Institutes of Health (NIH) estimates that the over-all costs of
cancer in 2007 were $226.8 billion: $103.8 billion for direct
medical costs (total of all health expenditures) and $123.0 billion for indirect mortality costs. Other barriers include the cultural beliefs, lack of knowledge, socioeconomic factors, access
to screening and treatment, and a lack of early detection practices (McCaskill, 2006).
Charlotte M. Wood
Dr. Joan S. Tilghman
Uninsured patients and those from ethnic minorities are
substantially more likely to be diagnosed with breast cancer.
According to the US Census Bureau (2010), almost 51 million Americans were uninsured in 2009; almost one-third of
Hispanics (32%) and one in 10 children (17 years of age and
younger) had no health insurance coverage.
Early Detection Techniques
Routine screenings are fundamental to early detection and
prevention of breast cancer. Included in routine screenings is
diagnostic testing such as mammography, ultrasound, and
breast magnetic resonance imaging (MRI), (Ravert & Huffaker, 2010). Early detection involves genetic counseling, clinical breast examinations (CBE), and self-breast examinations
(SBE). When individuals actively participate in early detection
techniques and routine screenings, evidence based practices
(EBP) suggests that breast cancer mortality and morbidity
rates decrease (McCaskill, 2006).
Community Strategies to Address Breast
Cancer Disparities
Strategies to address breast cancer disparities in African
American women involve engaging community leaders and
the creation of community based breast health education
programs. Breast health education programs are established
through churches and community associations. The programs
consist of encouraging CBE, SBE training, educational handouts, and the practice of regular exercise and eating of healthy
nutritious meals. The goal of the breast health education programs is to teach the participants to become more self-aware.
This strategy promotes a healthy lifestyle, engagement in early
detection practices, and the encouragement to follow-up abnormal findings. These measures are essential to the prevention of breast cancer, and will assist in the decrease in mortality
rates for African American women (Kelly, 2011).
CONTINUED ON PAGE 41
Cervical Cancer Vaccines:
What We Need to Know
NBNA.org — 9
Denise Linton, DNS, FNP-BC
F
or many decades the only strategy that was available to fight cervical cancer, a preventable cancer, was
screening with the Pap test. “Disparities in the cancer
burden among racial and ethnic minorities largely reflect obstacles to receiving health care services related to cancer prevention, early detection, and high-quality treatment...”(American
Cancer Society [ACS], 2012, p. 43). More than 90% of all cases
of cervical cancer are caused by the HPV and 70% of these
cases are caused by HPV types 16 and 18. At the moment,
there are two safe and effective vaccines that can prevent infection with the human papillomavirus (HPV) among 9 to 26
year old females. Healthy females clear the HPV but HPV may
persist and progress to cervical cancer in females who smoke,
engage in sexual activity at a young age, and have multiple sex
partners (ACS, 2012).
In addition to educating teenagers about reducing and
eliminating high risk behaviors, health care providers need to
become informed about the cervical cancer vaccines and subsequently educate parents, guardians, and teenagers about
the vaccines. In this way, they can make informed decisions
regarding being vaccinated.
Gardasil® is the first cervical cancer vaccine that was approved by the Food and Drug Administration (FDA) in 2006 and
it is indicated for the prevention of cervical, vaginal, vulvar, and
anal dysplasia and cancer caused by HPV types 16 and 18 and
genital warts caused by HPV types 6 and 11 in females and
males (Castle & Cox, 2010). Females and males between the
ages of 9 and 26 years of age are eligible for this vaccine which
is administered in three doses of 0.5 milliliters intramuscularly;
the second dose is administered two months after the first
dose and the third dose is administered six months after the
first dose (Monthly Prescribing Reference [MPR], 2012b). This
vaccine is contraindicated in females and males with yeast allergy and females who are pregnant or nursing mothers (MPR,
2012b). Adverse effects include those that are common to
other immunizations but syncopal episodes and subsequent
falls and injury may occur in individuals who receive Gardasil®
(Merck & Co., Inc, 2011). Therefore, vaccine recipients should
be observed for at least 15 minutes after receiving the vaccine.
Thromboembolic events may occur among females who are
on oral contraception pills or who have a family history of clotting disorders (Merck & Co., Inc). If these females decide to be
vaccinated they should be informed of the risk and signs and
symptoms of thromboembolic diseases.
Cervarix® was approved by the FDA in 2010 and it prevents
cervical dysplasia and cancer caused by HPV types 16 and 18
(Castle & Cox, 2010). Unlike Gardasil®, it is indicated for use
only among females between the ages of 10 and 25 years and
the second dose is administered one month after the first but
the third dose is administered six months after the first dose
(MPR, 2012a). Females who are allergic to latex or those who
are pregnant or nursing mothers should not receive Cervarix®
(MPR).
The vaccines prevent the development of cervical intraepithelial neoplasia 2 or greater that is caused by HPV 16 or 18
among women who have never been infected (Castle & Cox,
2010). Additionally, they are effective against cervical cancers
that are caused by HPV types that are closely related to HPV
types 16 and 18 and are the etiologic agents in 20% of all cases
of cervical cancer (Merck & Co., Inc, 2011). The average duration of protection against dysplasia and cancer is 42 months
but research study is in progress in order to determine whether
the duration of protection is longer (Merck & Co., Inc).
Additionally, individuals who miss a dose of vaccine do not
have to restart the series, it is not necessary to perform serology testing prior to vaccination nor is it necessary to monitor
individuals with titers after vaccination, individuals who have
had a positive HPV test result can be vaccinated, and Gardasil® can be administered at the same time as recombivax
HB, Menatra, and Adacel but they should be administered
at different sites (Merck & Co., Inc). Finally, while vaccination
should be promoted as a plausible strategy to reduce racial
and ethnic cervical cancer disparity, Pap testing should continue among eligible women.
References
American Cancer Society. (2012). Cancer facts & figures 2012. Retrieved
March 9, 2012 from http://www.cancer.org/acs/groups/content/@
epidemiologysurveilance/documents/document/acspc-031941.pdf
Castle, P, & Cox, J. (2010). Recommendations for the use of human
papillomavirus vaccines. Retrieved November 28, 2011, from http://
www.uptodate.com/contents/recommendations-for-the-use-ofhuman-papillomavirus-vaccine?view=print
Merck & Co., Inc. (2011). Gardasil. Whitehouse Station, NJ. Monthly
Prescribing Reference. (2012a). Cervarix. Retrieved May 1, 2012,
from http://www.empr.com/cervarix/immunization/drug/7722
Monthly Prescribing Reference. (2012b). Gardasil. Retrieved May 1,
2012, from http://www.empr.com/gardasil/immunization/drug/5305
Dr. Denise Linton is an assistant professor at the University of Louisiana at Lafayette in the College of Nursing and
Allied Health Professions. She is a founding member and the
1st vice president of Acadiana Black Nurses Association. Character statement: Health care providers need to become more
knowledgeable about the cervical cancer vaccines in order to
be able to discuss them with eligible females and their parents
or guardian.
10 — NBNA.org
The Silent Killer Among African American Children
Travis “Pete” Lewis, PhD, RN
Charlene Brown Smith, PhD, RN
Pamela Williams-Jones, MN, RN, WHNP
“The sorceress silently stalks the victims, the younger the child, the greater the trophy.”
H
igh blood pressure (hypertension) is called the
silent killer because it has no warning signs (Enersen,
n.d.). It is well established that primary hypertension
begins in childhood (Berenson, 1995). Presently, high blood
pressure, or hypertension, may spell worse heart trouble for
African American children under the age of 13 than for other
children of the same ages (Persheva, 2010). African American
children are more prone to left-ventricular hypertrophy, one of
hypertension’s earliest, most insidious and most complicated,
and is particularly most pronounced in children younger than
13 years of age (Persheva, 2010).
Persheva (2010) further reports that researchers found
that African American teenagers had more severe hypertension than teens from other races, and that blood pressures
remained in the dangerously hypertensive range for longer
periods. Although, a single episode of high blood pressure is
not hypertension, all children with one episode of high blood
pressure should be monitored. (Persheva, 2010).
Facts
Obese children are 3 times more likely to develop hypertension than children of normal weight (Rodriquez-Crug, Moore,
Spitzer& Windle, 2011). Younger African American children
have higher rates of obesity and being overweight, more likely
to have higher levels of rennin, the blood-pressure-regulating
hormone produced by the kidneys (Persheva, 2010), and are
twice as likely to have thickening of the heart muscle.
Risk factors
What leads to hypertension in children? Hypertension
may be the result of cardiac or renal pathology, or secondary to medications. Most often physician cannot determine
the direct cause and must rely on contributing factors. These
factors include family history, excess weight or obesity, and
race, particularly African Americans (High Blood Pressure in
Children, n.d.). The Bogalusa Heart Study tracked twenty four
hundred 5-10 year-old children for a mean of 17 years and
concluded that the children who were obese were more likely
to become obese adults than their Caucasian counterparts
(Berenson, 1995).
Education and Cultural Consideration
Understanding the characteristics that places a young
person at increased risk for hypertensive disease is critical
for developing approaches to intervention and preventing the
natural course of essential hypertension. Therefore, health
practitioners must first recognize that hypertension does exist
in children. The goal should be to identify and institute early
treatment and prevention to prevent organ damage and ultimately clinical disease (Berensen, 1995).
Berensen (1995) states the first approach to therapy for
prevention in childhood hypertension should be nonpharmacological. Berensen (1995) further recommends that prevention
be achieved through health education and health promotion
for all school children.
One of the primary roles of the nurse is teaching. Nurses
should be strong advocators in preventing this crippling disease. Nurses should stress to parents the importance of
setting a good example. Teaching topics should include the
dangers of second hand smoke, appropriate diet and regular
physical activity. Emphasis should be on teaching children to
adopt healthy lifestyles.
Culture has a profound effect on the development of one’s
attitudes and behaviors. According to Caprio, et al., (2008)
culture is believed to contribute to the disparities in childhood
obesity in numerous ways. These include development of
body image, child feeding practices, the type and frequency
of physical activity, the perception of risk and obesity, utilization of health services and the manner in which the risk varies
on social status. Furthermore, Caprio et al (2008) finds that
the risk for obesity should be routinely discussed by primary
care providers during even brief encounters with children and
their families.
Conclusion
There is a need for early diagnosis and prompt treatment of
high blood pressure in all children. Once again, a single episode
of high blood pressure is not necessarily hypertension, but all
children with one episode, should be closely monitored. Pesheva (2010) quoted Tammy Brady, MD, MHS, “pediatricians
should also keep in mind that African American patients may
develop worse complications or develop them sooner.” All children with hypertension should be referred to a kidney specialist
and have an ultrasound to check the heart muscle thickness
and function (Pesheva, 2010). As health care advocators it is
imperative that we are actively engaged in the prevention of
hypertension through health screening and education. The ultimate goal should be to prevent the sorceress from conquering
our children.
NBNA.org — 11
silent killer continued from page 10
References
American Heart Association (n.d.) High Blood Pressure in Children.
Retrieved from http://www.heart.org/HEARTORG/Conditions/
HighBloodPressure/UnderstandYourRiskforHighBloodPressure/
High-Blood-Pressure-in-Children_UCM_301868_Article.jsp
Berensen, G. (1995). The control of hypertension in African American
children: The Bogalusa study. Journal of the National Medical Association, 87 (Suppl), p. 614- 616.
Caprio,S., Daniels, S., Drewnowski, A., Kaufman, F., Palinkas, L.,
Rosenbloom, A., & Schwimmer, J. (2008). Influence of race, ethnicity, and culture on childhood obesity: Implications for prevention
and treatment. Diabetic Care, 31(11), p. 2211-2221.
You
Belong
Here
Cruz-Rodrigues, E. Moore, J., Spitzer, A., Windle, M. Pediatric Hypertension. (2011). Retrieved from http://www.Medience.medscape.
com/article/889877-overview#aw2aab6b2b5
Enersen, J. (2011). African American children are hit hard by hypertension. Retrieved from http://www.king5.com/health/childrenshealthlink/African-American-boys-are-hit-hard-by-hypertension-113091189.html
Pesheva, E. (2010). High blood pressure may take greater toll on
youngest black children’s hearts. Retrieved from http://www.hopkinschildrens.org/High-Blood-Pressure-May-Take-Greater-Toll-onYoungest-Black-Children-s-Hearts.aspx
Dr. Travis “Pete” Lewis received his BS degree from
Mobile College in 1970. His Diploma in Nursing from Providence School of Nursing in 1973. His Master in Nursing Degree
from the Medical College of Georgia in 1975. Earned his PhD in Philosophy from the University of Southern Mississippi in
2005 with a focus on curriculum design. Is currently employed
as faculty at Nicholls State University in the Department of
Nursing.
Dr. Charlene Brown Smith received her BS Degree
in Nursing from Dillard University in 1978. Later received her
Master Degree in Nursing from LSU in 1986. Earned her PhD in Nursing from Southern University with a focus on African
American women and breast cancer in 2008. Is currently employed as faculty at Nicholls State University in the Department
of Nursing.
Pamela Williams-Jones received her BS Degree in
Nursing from Southeastern Louisiana University in 1981. Later
received her Master Degree in Nursing from LSU in 1986. Received her Women’s Health Nurse Practitioner from the University of South Alabama. Currently pursuing PhD in Natural
Health Sciences . Pamela is currently employed as faculty at
Nicholls State University in the Department of Nursing.
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12 — NBNA.org
African American Infant Mortality:
An Urgent Cry–Bridging the Gap
Jennifer Jeames Coleman, PhD, RN, CNE
I
n 1979 the United States federal government began
a program targeted at improving the overall health of its
citizens. With the goal of ensuring a healthy future for all
Americans the US Department of Health and Human Services
(2010) began the Healthy People Initiatives. Over the last three
decades, objectives related to health promotion and disease
prevention have included the elimination and/or reduction of
health disparities. When assessing the well-being of America’s
children, infant death rate is an important health indicator.
Alarming statistics
While US infant mortality rates continue to decline nationwide, there remains a significant disparity in rates of death
among African American infants and the majority population.
The infant death rate for African Americans is over twice that
of Whites. Overall US infant mortality rate is 6.75 deaths per
1,000 live births. When listed by race and ethnicity however,
considerable variation is seen. The highest infant mortality rate
is 13.31 per 1,000 live births for non-Hispanic African American mothers. That is more than twice the rate of 5.63 for nonHispanic Whites (National Center for Health Statistics, 2008).
Of the leading causes of infant deaths, sudden infant death
syndrome (SIDS) ranks third. As with the death rate, gaps in
incidence of SIDS exist with African American infants suffering
disproportionately.
A matter of justice
Infant sleep environment is consistently linked to SIDS occurrence with documented high associations between prone
sleeping and SIDS occurrence. Thus, the American Academy
of Pediatrics recommends that all healthy infants be placed
supine for sleep. After a nationwide “Back to Sleep” campaign
was begun in 1992, a dramatic decrease in rates of SIDS occurred. The decline in SIDS deaths was, and remains disproportionately less in minority groups. Research further indicates
that this racial disparity is also seen in infant sleep positioning.
Significant numbers of African American infants are still being
placed prone to sleep. The resultant disparity in sleep patterns
and increased occurrence of SIDS are closely associated with
the persistent gap in infant mortality rates for African American
infants. Possible reasons for African American parents’ lack of
adherence to safe sleep recommendations include the lack of
health teachings that are respectful of the values and beliefs of
the individual. Despite the fact that African American parents
consistently report having heard about supine sleep position
recommendations, lack of trust of health care providers is a
barrier to their adherence. Shortly after initiation of the “Back to
Sleep” campaign a large study of inner city African American
parents revealed that only 54% of families reported that they
followed the supine sleep advice they had been given by clinic
personnel (Ray, Metcalf, Franco, & Mitchell, 1997). Reports
continue to suggest that care recipients are less likely to follow
the advice of health care providers if
recipients are distrustful and/or if actions and behaviors of care providers are perceived as discriminating
or disrespectful.
Call to action
African American parents are more likely to adhere to
health education suggestions if received from nurses who are
friendly, attentive, and respectful. The nurse’s behavior and attention are critical to the parents’ perceptions of care. Parents
consistently report that nurses who respect family’s cultural
values are trustworthy (Coleman, 2009). Thus, to positively
impact the infant mortality rate of African Americans, nurses
must provide culturally congruent care that is meaningful and
inclusive of family views. African American parents are more
likely to adhere to teaching related to safe infant sleep position if nurses are friendly, concerned, and attentive (Coleman,
2009). Family involvement in teaching as a source of strength
is also important to African American parents. Consequently,
nurses must include family members when counseling parents
on the importance of supine sleep position for infants. Nursing
behaviors that include a family’s cultural values are meaningful and lead to increased trust in nursing care. Parents who
feel respected perceive that the nurse will protect and care for
their infant appropriately and are more receptive to the nurse’s
recommendations. As a result, increased African American
parent adherence to supine sleep position can be expected.
The resultant behavior change of parents will ensure safer care
and first year survival of significant numbers of African American infants.
References
Coleman, J. J. (2009). Culture care meanings of African American parents related to infant mortality and health care. Journal of Cultural
Diversity, 16(3), 109-119.
National Center for Health Statistics (2008). Recent trends in infant
mortality in the United States. NCHS Data Brief. Retrieved May 3,
2012 from http://www.cdc.gov/nchs/data/databriefs/db09.htm
Ray, B. J., Metcalf, S. C., Franco, S. M., & Mitchell, C. K. (1997). Infant
sleep position instruction and parental practice: Comparison of a
private pediatric office and an innercity clinic. Pediatrics, 99, 12.
US Department of Health and Human Services (2010). Healthy People
2020 Framework. Retrieved May 3, 2012 from http://www.healthypeople.gov/2020/Consortium/HP2020Framework.pdf
Dr. Jennifer Jeames Coleman is an Associate Professor
at the Ida V. Moffett School of Nursing in Samford University,
Birmingham, AL. She is the Vice President of the Birmingham
Black Nurses Association and chair of the education committee and mentorship program.
The Anti-Vaccine Movement:
NBNA.org — 13
Taking Preventative Medicine in the Wrong Direction
Brent Straley, MSN, MBA, RN, CPN
T
he anti-vaccine movement may seem like a recently new cause, but the history of the anti-vaccine
movement can go back to 1722 when the inoculation
of smallpox was just beginning, with a sermon entitled, “The
Dangerous and Sinful Practice of Inoculation” by Rev. Edward
Massey (“March 18th,” n.d.). The belief then, and for some
to this day, is that these diseases are sent by God to punish
those who sin. The vaccine movement we recognize now,
which focuses heavily on the measles-mumps-rubella (MMR)
vaccine, started in 1998 with a research study authored by
Dr. Andrew Wakefield. His research showed a connection between the MMR vaccine and autism (Wakefield et. al., 1998).
However, this research was later discredited and retracted
in 2010. The anti-vaccine movement increased rapidly in
2007 when a popular celebrity appeared on several television shows and published books advising parents not to get
their children immunized. The increase in the anti-vaccine
movement was also supported by the improvement to obtain
information via the Internet.
The anti-vaccine movement has caused an increase in
children not being vaccinated. Pertussis, another preventable
disease, in which the first immunization is given to an infant at 2
months of age, has been on the rise as well. In California alone,
there were over 9000 cases of pertussis in 2010, more than the
state has had since 1947 (Diekema, 2012). California’s rate of
vaccine exemption has also increased to 2.5% in 2010, which
makes it the largest rate of declined vaccines in California since
1978 (Kumar, 2011). Other areas of the country can be higher
than this.
As more parents prevent their children from getting vaccinated out of self-interest, they are putting the public at risk. In
the case of measles, because it is so contagious, at least 96%
of the country’s population must be vaccinated to obtain herd
immunity (Poland, 2011). Herd immunity is what protects those
who do not qualify for the vaccine, such as children less than
12 months old and the immunocompromised. The herd immunity of measles is already being compromised. There were over
three times as many measles cases reported than are seen in
a typical year alone in the first six months of 2011. According to
the Centers for Disease Control and Prevention (CDC, 2012),
the country had a total of 222 cases and 17 measles outbreaks
in 2011. From 2001-2010, the yearly mean was 60 cases and
only 4 outbreaks (CDC).
The anti-vaccine movement took a toll on the public. An
investigation into Dr. Wakefield’s work, showed that he participated in fraud in order to manipulate his data to show a relation
between the MMR vaccine and autism. His research that was
published in The Lancet was retracted immediately in 2010.
Now there are more than 20 studies that show no link between
the MMR vaccine and autism. Scientific societies have also
claimed that there is no reason to suspect a link between the
MMR vaccine and autism. Although Dr. Wakefield’s research
has been found to be fraudulent, the damage has been done.
Thousands of kids may not have received the vaccine causing
some preventable illnesses and even deaths (Poland, 2011).
While there will always be exemptions to vaccines, health
care and the country as a whole needs to reeducate society
in order to decrease the amount of unvaccinated children. This
will be increasingly harder as the generation shift continues into
the parents who were not alive when these diseases did not
have vaccines available. The diseases we are protecting not
only our children from, but also our society from, are diseases
that are highly contagious and can cause serious harm, and
even death. Now that serious harm and death are rarely seen,
and that immunizations are close to but not 100% effective, it
is easier to say that the vaccines are dangerous and not the
disease.
References
Centers for Disease Control and Prevention. (2012). MMWR weekly:
Measles - United States 2011. Retrieved from http://www.cdc.gov/
mmwr/preview/mmwrhtml/mm6115a1.htm
Diekema, D. S. (2012, February) Improving childhood vaccination
rates. The New England Journal of Medicine, 366, 391-393. Retrieved from http://www.nejm.org
Kumar, S. V. (2011, September 26). Thousands in Calif. started school
without vaccines. USA Today. Retrieved from http://www.usatoday.
com
March 18th. (n.d.). The Hyperlinked & Searchable Chambers’ 1869
‘The Book of Days’. Retrieved from http://www.thebookofdays.
com/months/march/18.htm
Poland, G. A. (2011) MMR vaccine and autism: Vaccine nihilism and
postmodern science. Mayo Clinic Proceedings, 86(9), 869-871.
doi: 10.4065/mcp.2011.0467
Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, D. M.,
Malik, M., Walker-Smith, J. A. (1998). Ileal lymphoid nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in
children [retracted]. The Lancet, 351(9103), 637-641. doi:10.1016/
S0140-6736(97)11096-0
Brent Straley is a Charge Nurse at Children’s Mercy
Hospitals and Clinics in Kansas City, Missouri, in the hospitals
primary care clinic.
14 — NBNA.org
Childhood Trauma:
An Opportunity for Nurses to Engage
Adrienne M. Smith, PhD, MS, CHES
T
rauma occurs whenever an external threat overwhelms a person’s coping resources (Report of the
Federal Partners Committee on Women and Trauma,
A Federal Intergovernmental Partnership on Mental Health
Transformation, A Working Document, 2011). It can stem from
physical, emotional, or sexual abuse, disasters, war, violence,
or childhood neglect, according to the Substance Abuse and
Mental Health Services Administration (SAMHSA), within the
U.S. Department of Health and Human Services (HHS). These
distressing events may have long-lasting, harmful effects on a
person’s physical and emotional health and well-being (http://
www.integration.samhsa.gov/clinical-practice/trauma).
In the United States, 61% of men and 51% of women report
exposure to at least one lifetime traumatic event, and in public
behavioral health settings, 90% of clients have experienced
trauma (http://www.integration.samhsa.gov/clinical-practice/
trauma). These traumatic events can be singular or multiple
events over time, that leave victims feeling terrified, humiliated,
and threatened.
In 2009, researchers found that more than 60% of youth
age 17 and younger have been exposed to crime, violence,
and abuse either directly or indirectly, including witnessing a
violent act, assault with a weapon, sexual victimization, child
maltreatment, and dating violence. Moreover, nearly 10% were
injured during the exposure to violence, 10% were exposed
to maltreatment by caretaker, and 6% were a victim of sexual
assault (http://www.samhsa.gov/children/data.asp).
Evidence now exists that unaddressed, and sometimes
concealed, childhood trauma may have long-term physical
and emotional consequences that compromise health status
as an adult. The ongoing Adverse Childhood Experiences
(ACE) Study, being conducted by Drs. Vincent Felitti and
Robert Anda, examines whether and how childhood experiences affect adult health. They followed over 17,000 patients
for adverse experiences in childhood, including living in a
home with domestic violence, experiencing emotional, physical or sexual abuse as a child, having an alcoholic or drugaddicted parent, having a mentally ill family member, having
an incarcerated parent, and experiencing neglect (http://
www.cdc.gov/ace/index.htm).
They found adverse childhood experiences had a profound
effect on adult health and well-being decades later, and certain
childhood experiences were major risk factors for the leading causes of illness and death in the United States. Furthermore, with multiple, complex traumatic experiences, the risk
of compromised adult health increased. This groundbreaking
study suggests that advances in the prevention of chronic
disease morbidity and mortality, as well as social problems,
could be obtained from a better understanding that many of
these circumstances arise, at least in part, because of adverse
childhood experiences. If childhood
trauma is recognized and addressed
early (in childhood), the possibilities
for better adult health are greater.
Trauma-informed care is a service approach based on
universal precautions and organizational sensitivity. This approach incorporates 1) an appreciation for the high prevalence
of trauma experienced by persons receiving services; and
2) an understanding of the profound neurological, biological,
psychological, and social effects of trauma and violence on
the individual. Trauma-informed organizations, programs, and
services provide patient-centered care, and understand possible vulnerabilities of trauma survivors that traditional service
delivery approaches may overlook or exacerbate. In addition,
these services are more supportive and consciously aim to
avoid re-traumatization (http://www.samhsa.gov/nctic/trauma.
asp).
A skilled and well-trained provider could recognize that
a traumatic event has occurred, identify the symptoms, and
assist with navigating appropriate care and treatment. Yet,
many survivors are resilient for various reasons, and require
limited or no recovery care. Factors that influence how an
individual adapts are numerous, but with help from families,
providers, and the community, children and youth can demonstrate resilience when dealing with trauma.
SAMHSA’s National Center for Trauma-Informed Care
(NCTIC) is one resource for technical assistance to health care
professionals. NCTIC offers consultation and training, education and outreach, and resources to support a broad range
of service systems, including systems providing mental health
and substance abuse services, housing and homelessness
services, child welfare, criminal justice, and education. The
center also provides guidance for trauma-specific interventions, national hotlines, referral resources, and support services (http://www.samhsa.gov/nctic/default.asp).
All health care professionals need to provide trauma-informed care. Pediatric health professionals, especially nurses,
play an important role in this effort. Nurses have a unique opportunity to engage children and provide a safe and supportive
care environment that nurtures children into resilience and recovery. Making the commitment to be aware of and respond to
the physical and emotional needs of children will foster positive
life-long health outcomes.
Dr. Adrienne M. Smith is a Public Health Advisor with
the U.S. Department of Health and Human Services’ (DHHS)
Office on Women’s Health (OWH). Within the Division of Outreach and Collaboration, she manages programs and outreach
activities focused on minority women’s health, and girl/adolescent health promotion.
The New Call to Action:
Babies are Born to Breastfeed
NBNA.org — 15
Phyllis W. Sharps, PhD, RN, CNE, FAAN
M
others of newborns are faced with many
decisions, including how best to feed their infants.
The decision about feeding methods, formula feeding or breastfeeding is a personal choice. The major medical
groups and governmental agencies that are charged with
making recommendations for parenting practices that are
most associated with optimal infant and child health and wellbeing. Professional and governmental groups such as the
American Academy of Pediatrics (AAP), Centers for Disease
Control and Prevention, Health and Human Services, have
all recommended breastfeeding as best. For example, AAP
still recommends that despite economic, cultural and political
influences on decisions about infant feeding, breastfeeding
is the preferred method for infant feeding, and it ensures the
best possible health for infants and onto childhood (American
Academy of Pediatrics, 2005). The Surgeon Generals’ Call to
Action to Support Breastfeeding also supports AAP’s recommendation stating, “given the importance of breastfeeding for
the health and well-being of mothers and children, it is critical
that we take action across the country to support breastfeeding” (Health and Human Services, 2011).
Breastfeeding has important health benefit for both mothers and infants. Maternal benefits include: less bleeding immediately after deliver, quicker recovery of the reproductive organs
to their pre-pregnant statues, swifter return to re-pregnant
weight (American Academy of Pediatrics, 2005). Breastfeeding is also associated with decreased risk for certain cancers
breast cancer (rates reduced by 28%); ovarian cancer (rates
reduced by 27%) (Chung, Raman, Chew, Magula, DeVine, Trikalinos, & Lau, 2007). Other studies suggest that there are decreased risks for osteoporosis among women who breastfeed
their infants (Patton, Alexander, & Nowson, 2003). Maternal l
breastfeeding maybe an important strategy for reducing health
disparities related to cancer and obesity (Sharps, 2009).
There is much research that provides of the benefits of
breastfeeding for infants that last into childhood and adulthood.
These benefits include: lower incidence of certain viruses,
lower incidences of respiratory illness; reduction in ear infections and meningitis, protection against developing allergies
(Voices for American Children, 2010). Other research studies
have shown that governmental studies such from the national
Institute of Environmental and health Sciences found that there
is a 20% lower risk of breastfeeding babies dying between 28
days after birth through the first 2 months of life; that there is a
connection between breastfeeding and cognitive development
(higher intelligence) and also there is a connection between
breastfeeding and a lower incidence of obesity as a teen and
adult. Both for infants and mother breastfeeding can be an important strategy for reducing health disparities related to infant
mortality, and obesity for African American children (Voices for
American Children).
Despite all of the benefits and health related reasons for
choosing to breastfeed, the rates among African American
mothers still lags behind other groups. African American mothers have the lowest rates for initiate breastfeeding (54.4%);
continuing to 3 months (26.6%) and continuing through to 6
months (11.7%). AAP recommends that infants be exclusively
breastfed through 6 months of life. There are many structural
or cultural barriers that may influence African American mothers to breastfeed. Barriers include lack of knowledge about the
benefits of breastfeeding as well as techniques for breastfeeding; lactation problems and no support to help mothers resolve
issues related to baby latching on, poor suck, poor milk supply;
poor family and social support; social norms and values that do
not support breastfeeding; embarrassment; employment and
child care issues and health care services including access
and poorly trained health providers to support breastfeeding.
NBNA fully supports “babies are born to breastfeed.”
NBNA recognizes that although rates of breastfeeding have
risen slightly among African American women, breastfeeding
initiation and duration rates among African Americans and
Hispanics still lag behind the Healthy People 2020 goals for
breastfeeding initiation and duration. Low income and low
levels education make it even more difficult for women of color
to initiate and maintain exclusive breastfeeding for 6 months.
Barriers such as lack of education about the benefits of breastfeeding, lack of health care provider and family support, the
need to return to work and barriers in the work place are a few
of the obstacles women of color face as they attempt to start
and maintain breastfeeding.
NBNA members can support the recent Surgeon General’s
Call To Action to Support Breastfeeding by:
n Educational campaigns targeting the benefits of breastfeeding for women and infants emphasizing breastfeeding
as a low cost, and effective strategy for addressing health
disparities among African American women and infants.
Breastfeeding is an important strategy to include in all efforts to reduce and prevent health disparities as African
American women, infants and children suffer disproportionate burdens specifically in terms of certain cancers,
obesity, diabetes and infant and childhood infections.
16 — NBNA.org
General Health Care
The Million Hearts Initiative
John Michael O’Brien, PharmD, MPH
Liana Orsolini-Hain, PhD, RN
T
he National Black Nurses Association has a
long track record of promoting initiatives which promote
health. By promoting population health nurses can be
a leading force in improving the health of our nation. Getting
involved with the Million Hearts Initiative is an evidence-based
way to improve the cardiovascular health of Americans.
Million Hearts is a national initiative led by the Department
of Health and Human Services (HHS) to prevent 1 million heart
attacks and strokes in the U.S. by 2017. It aligns existing efforts and is creating new programs to improve heart health
and help Americans live longer, more productive lives. The
Centers for Disease Control and Prevention (CDC) and the
Centers for Medicare & Medicaid Services (CMS), co-leaders
of Million Hearts, are working alongside other federal agencies
and private- and public-sector organizations to make a lasting
impact against cardiovascular disease. Million Hearts has two
key components:
n Community prevention activities to prevent tobacco use
and reduce sodium and trans fat consumption, decreasing
the number of people who need medical treatment, and,
n
Clinical prevention activities to improve care for those who
do need treatment by encouraging a targeted focus on the
“ABCS”—aspirin for people at risk, blood pressure control,
cholesterol optimization and smoking cessation—which
address the major risk factors for cardiovascular disease
and can help to prevent heart attacks and strokes.
Million Hearts aims to achieve the ABCS goals by promoting an enhanced focus on cardiovascular disease prevention in
health care facilities and health care systems, including a focus
on these key “pillars”:
n Developing a simple, uniform set of measures for the
ABCS, ensuring that the data used to calculate the measures moves seamlessly within the flow of care, minimizing
the burden of collection and reporting of outcomes, and
linking high performance on these measures to recognition
and reward. Nearly 50 Health and Human Service (HHS)
rules, regulations, and grant programs have aligned their
performance measures, reporting measures, or other program elements with the aims of the Million Hearts initiative.
n
Fully deploying health information technology including:
clinician use of registry functions to identify gaps in care,
intervene, and track progress of people with high blood
pressure or elevated lipids; point-of-care risk assessment
tools to ensure that interventions are targeted to individuals most likely to benefit; clinical decision support that is
patient-specific ensuring that the right care is delivered
the first time and every time; and electronic reminders to
help consumers adopt and stick to new health habits (e.g.,
medication adherence).
n
Discovering and spreading clinical innovations that focus
on the ABCS and recognize and reward value and outcomes over volume and process, such as team-based
care, patient-centered medical homes and interventions
to promote medication adherence. In addition to nurses,
physicians and physician assistants, pharmacists, cardiac
rehabilitation teams, health coaches, community health
workers, and peer wellness specialists are among many
powerful change agents who can support healthy behaviors and improve the appropriate use of medications.
What can your organization do to promote the Million
Hearts Initiative? Here are some easy first step ideas:
n Take a personal pledge to decrease your risk of heart attacks and strokes (http://millionhearts.hhs.gov/be_one_
mh.html). Have a pledge drive among your organization
members and in your community. Convince your family and
friends to pledge.
n
Print out and distribute our Consumer Fact Sheet to your
family, friends, and patients and also place them in public
places. This fact sheet is found in the partnership toolkit
(http://millionhearts.hhs.gov/resources/toolkits.html)
n
Sponsor an Inter-professional Grand Rounds using the
Grand Rounds toolkit
n
Take it, Say it, Explain it. Commit to always stating the blood
pressure and pulse to everyone you assess and explain
what it means in terms of the American Heart Association Guidelines for Blood Pressure http://www.heart.org/
HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp
Dr. John Michael O’Brien is a Senior Advisor at the CMS
Innovation Center and to Million Hearts, a U.S. Department of
Health and Human Services initiative with the explicit goal to
prevent a million heart attacks and strokes in five years. He
joined Million Hearts after launching and serving as Field Director for the HHS Partnership for Patients, a public-private
partnership to reduce preventable hospital-acquired conditions by 40% by 2013, and improve care transitions such that
readmissions are reduced by 20% by 2013. Prior to joining the
NBNA.org — 17
General Health Care
The Air We Breathe
Unhealthy air remains a threat to the lives and health of millions of families
in the United States, despite the great progress made with the Clean Air Act.
Stephanie Owens
I spent my childhood in Detroit, MI, and many of my
adult years in Los Angeles, CA—two places listed in a 2011
American Lung Association report ranking the top 20 polluted cities in America. Some days were better than others,
and on the bad days, I noticed more of my peers struggled with
symptoms of asthma or other respiratory ailments.
I’m not a scientist or health practitioner by trade, but it was
easy to make the connection between the days with a lot of
smog and haze in the air and my co-workers asthma attacks.
With such an obvious correlation between asthma symptoms
and air quality, I wondered why I hadn’t heard more about this
disease and its causes while growing up.
In my current role as deputy associate administrator for the
Office of External Affairs and Environmental Education at EPA,
I help disseminate information about the indoor and outdoor
environmental factors that can trigger asthma attacks such as
ozone and particulate pollution, dust mites, molds, cockroaches, pet dander and secondhand smoke. I engage stakeholders and think of innovative ways we can spread our message
about public health and the environment.
Air pollution lingers as a widespread and dangerous reality—even as some seek to weaken the Clean Air Act, the public
health law that has driven cuts in pollution since it was passed
in 1970. The State of the Air 2011 report by the American Lung
Association shows that air quality in many places in the US
has improved, but more than 154 million Americans—just over
one half of the nation—still suffer pollution levels that can be
dangerous to breathe.
Asthma is one of the most common serious chronic
diseases affecting children. An average of one out every 10
school-aged children has asthma. The rate is even higher for
African American children at 16 percent—among the highest
of all minority groups. Among children with asthma, African
American children are twice as likely to be hospitalized or have
an emergency room visit. They are also more than four times
more likely to die due to asthma than white children.
This disparity has encouraged me to think creatively on how
to get the message out about the environment and asthma
triggers. My staff works with various stakeholder organizations
to educate them and their networks through social media and
public events with EPA staff. During the month of May, we
marked National Asthma Awareness month by working with
our partner organizations to educate their membership on
screening for asthma, and provide guidance and better access
to resources on this chronic disease (www.epa.gov/asthma).
While this is an important step, we have a lot more work
ahead of us. That’s why we look to organizations such as National Black Nurses Association, who day in and day out are
at the front lines dealing with families and their children who
struggle with the realities of asthma. Both NBNA and EPA
have missions to protect public health. By working together,
we can raise awareness and make the connection between
environmental hazards and its impact on the health of our
communities.
Engaging the American people through organizations like
NBNA is one of the most powerful ways to affect change. I look
forward to working with NBNA and its members to promote
healthier environments where children live, work, and play.
Please take the time to review the resources below.
Asthma Fact Sheet:
http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf
Community Asthma Network:
www.AsthmaCommunityNetwork.org
Check the Air Quality near You:
www.Airnow.gov
Stephanie Owens is the Deputy Associate Administrator
for the Office of External Affairs and Environmental Education
in the Office of the Administrator at the United States Environmental Protection Agency
Million hearts (continued from page 16)
Department of Health and Human Services, Dr. O’Brien was a
Professor of Clinical and Administrative Sciences at the College
of Notre Dame School of Pharmacy and a Health Policy Fellow
in the United States Senate.
Dr. Liana Orsolini-Hain is a 2011-2012 Robert Wood
Johnson Foundation Health Policy Fellow serving in the Immediate Office of the Secretary of Health, Health and Human
Services. She is an Advisory Board member for the Million
Hearts Initiative and is working to mobilize nurses nationally to
improve the health of families, communities and populations.
She is also on the Centers for Medicare and Medicaid (CMS)
Nursing Steering Committee. She was a member of the IOM
Committee on the Initiative on the Future of Nursing: Leading
Change, Advancing Health, which produced recommendations for an action-oriented blueprint for the future of nursing.
18 — NBNA.org
General Health Care
Prostate Screening:
A Race for Awareness
Richard Cooks, RN
I
n the United States, the Centers for Disease Control and
Prevention (CDC, 2011) identifies the following four cancers
as the leading cause of cancer death among men: Lung,
Prostate, Colorectal, and Liver. While statistics show that lung
cancer is responsible for the majority of cancer deaths among
men, prostate cancer is the most common cancer diagnosis
in the adult male population (CDC). The CDC estimates that
223,307 men are diagnosed annually, and unfortunately, 13%
(29,093) of them die (2011). Even though prostate cancer is a
commonality among men of all races, African American men
succumb to the disease more often than other races; for example, the general male population has a 1 in 33 chance of
dying from prostate cancer while African American males have
a 1 in 19 chance (Prostate screening guide, 2003). This health
disparity prompted the CDC to develop the Prostate Screening Guide: A Decision Guide for African Americans. While the
guide provides 20 pages of informative literature, it emphasizes
risk factors, signs and symptoms, prevalence, and health promotions and maintenance.
health promotions and maintenance
Although the exact cause of prostate cancer is surrounded
by dubiety, along with the CDC, Ignatavicius & Workman (2010)
identifies increasing age, high fat diet, familial predisposition,
vitamin D and E deficiencies, and environmental substances as
a few risk factors (1719).
Prevention is the key to combating prostate cancer. Prostate screening targets asymptomatic men in order to detect
signs, symptoms, and risk factors early (Prostate screening
guide, 2003). With screening, modifiable risk factors, such as
diet, environmental influences and nutritional deficiencies can
be alleviated (Prostate screening guide, 2003). As nurses, we
have a responsibility to teach men and their families about
prostate cancer and its associated screening guidelines. In
particular, the Birmingham Black Nurses Association, is fulfilling our responsibility to the Birmingham Metropolitan area by
participating in community and church sponsored health fairs.
Using the CDC and American Cancer Society’s guidelines for
prostate cancer screening, we inform all patrons who visit our
booth that a Prostate specific antigen (PSA) test and digital
rectal examination (DRE) should be performed annually on the
following men: Men of the age 50 and older; African American
men and any man age 45 with a first degree relative with prostate cancer; and men of the age 40 who have two or more first
degree relatives with prostate cancer. We teach all men that
the DRE is the physical examination of the prostate, in which a
health care provider inserts a gloved finger into the rectum to
palpate the prostate for abnormalities. In terms of the PSA, we
inform men that blood is collected and PSA levels are screened
for elevation(Prostate screening guide, 2003).
Signs & symptoms
conclusion
risk factors
Most men are asymptomatic, however, others might experience blood tinged urine, trouble urinating, urine retention,
frequent trips to the bathroom, painful urination or intercourse,
or pain that radiates throughout the pelvis, flank, or bones. In
regards to prevalence, men older than 60 and men with a first
degree relative with prostate cancer are at the greatest risk
(Prostate screening guide, 2003).
Fear and anxiety is a normal reaction to health care procedures and laboratory test. However, as nurses, we can relieve
some of the fear and anxiety of prostate screening by providing accurate and complete knowledge. In turn, more men will
visit their health care providers for screening. I end with this
question and hope that it will be a topic at your next chapter
meeting, “How many men have you encouraged to partake in a
prostate screening and what literature do you have available to
distribute to your community?
References
Ignatavicius, D. D., & Workman, M. L. (2010). Medical-surgical nursing,
patient-centered collaborative care. (6th ed.). St.Louis, Missouri: W
B Saunders Co.
U.S. Department of Health and Human Services, Centers for Disease
Control and Prevention (CDC). (2003). Prostate screening guide: A
decision guide for African Americans.
General Health Care
NBNA.org — 19
Christensen Rallying National and Local Organizations to
Support Her Efforts to Oppose Cuts to the Territories Medicaid Program
T
hough her amendment to strike the language that
would deliver a crippling blow to the U.S. Virgin Islands
and other territories’ Medicaid programs was voted down
yesterday on a roll call vote along party lines, Congresswoman
Donna Christensen has no intentions of letting up on her efforts
to oppose the Republicans’ efforts to protect and preserve the
Medicaid funding for the territories that was achieved under the
Affordable Care Act.
“The Republicans—in an effort to cut their portion of the
more than $96 billion from the deficit over the next decade—
are targeting the territories’ Medicaid programs in a manner
that is unjust, unnecessary and socially, economically and
medically irresponsible,” noted Congresswoman Christensen.
“These proposed cuts have nothing to do with the unmet medical needs in the territories, nor do these proposed cuts consider the health and wellness of the men, women and children
in the U.S. Territories whose health care needs surpass their
financial resources.”
“As a Member of the Energy and Commerce Committee,
who—along with my delegate colleagues—fought extremely
hard to achieve the $6.3 billion increase in Medicaid over the
next decade and the FMAP increase to 55 percent, there is
simply no way that I can or will sit idle and watch this unfold
without exhausting every avenue I have to stop it” added Congresswoman Christensen, a physician who also Chairs the
Congressional Black Caucus Health Braintrust. “This is particularly true when I consider that the successes we achieved
under the Affordable Care Act that put the U.S. Virgin Islands’
Medicaid program on a glide path to parity.”
In addition to introducing her amendment, Congresswoman
Christensen also called on local, regional and national organizations to register their support. Today, dozens of organizations
have expressed their formal support for the Delegate’s efforts
to strike the Republican language attacking the territories’
Medicaid programs.
“Given all that is at stake, this fight is far from over and I am pleased that so many local and national organizations have
expressed their support for my efforts and those of my delegate colleagues to protect our Medicaid programs and—more
importantly—the individuals they serve,” expressed Congresswoman Christensen. “I am confident that together, we can and
will ensure that these unethical and unfair recommendations
never truly come to fruition, and that the health, wellness and
thus life opportunities of Virgin Islanders and other individuals
in the territories are preserved and protected.”
Nurses’ Health Study is recruiting “The Next Generation”
The Nurses’ Health Study is recruiting 100,000 nurses for the “next generation” of its landmark
research on women’s health-NHS3.
Female RNs, LPNs, and nursing students ages 20-46 across the US and Canada are eligible to
become part of this world-renowned study.
Much of what we know about health today—from the risks of tobacco and trans fat to the benefits
of physical activity and whole grains—is thanks to the Nurses’ Health Study. It has provided valuable
insight into the unique health challenges that nurses face, like shift work and occupational exposures.
More than 250,000 nurses have participated since the study began in 1976, and 90% of them are
still engaged.
NHS3 will continue to explore the long-term effects of lifestyle on health among a younger and more
diverse population of women that the previous two cohorts. It also looks at new issues like nurses’ work
life and adolescent diet.
If you’re eligible, NBNA encourages you to learn more and join on the study’s website (www.nhs3.
org). After you’re enrolled, you’ll be asked to complete the online study’s confidential questionnaires.
Participation takes about one hour per year.
If you’re not eligible, we hope you will help spread the word among your colleagues and encourage
them to help change the future of women’s health.
For more information, please visit the NHS3 website: www.nhs3.org.
20 — NBNA.org
NBNA Nurse Leadership
Prescription Drug Abuse:
The Nation’s New Drug Epidemic
Janice Phillips, PhD, RN, FAAN
Associate Professor, Rush College of Nursing, Rush University
P
rescription drug abuse is now the country’s
fastest growing drug problem. While prescription drug
abuse, misuse and diversion are not new, this growing
epidemic has stimulated a call to action on a number of fronts
including the United States Congress. During the 112th Congressional session, lawmakers introduced several legislative
proposals in response to this growing epidemic. While each
legislative bill seeks a solution to prescription drug abuse from
a different perspective some offer a comprehensive approach
to this complex issue. OxyContin and Vicodin are among the
most frequently abused prescription painkillers and Xanax and
Valium are the most frequently abused central nervous system
depressants. Concerta and Adderall are among the most frequently abused prescribed ADHD medications. Sadly, more
and more people are abusing over the counter drugs such as
DXM (dextromethorphan), the active cough suppressant found
in many over-the-counter cough and other cold medications.1
Recent data reveal that 7.0 million persons reported past
month use of non-medical psychotherapeutic drugs, this
equates to 2.8% of the U.S population.2 The same survey revealed that prescription drug use was highest among young
adults aged 18-25, with 6.3% reporting nonmedical use of
prescription drugs in the past month prior to the survey. Older
adults are another high-risk population. Persons age 65 and
older are particularly at risk because they are more likely to
be prescribed long term and numerous medications. Other
vulnerable populations include individuals taking multiple controlled substances from multiple providers, people who take
high daily doses and those who abuse numerous abuse prone
prescription drugs, low income individuals residing in rural
areas. The increased availability of prescription drugs, the push
for aggressive pain management along with misconceptions
regarding the addictive potential of prescription drugs in part,
are contributing to this epidemic.
This growing public health epidemic has resulted in numerous legislative proposals in Congress. Legislation introduced
during the 112th legislation includes a focus on stricter penalties for “pill mill” operators, education for providers with prescriptive authorities, consumer education and state funding
to better support state drug monitoring programs. The author
worked on Senate Bill 507 during her Fellowship in the office
of Senator John D Rockefeller. Briefly, S 507, The Prescription
Drug Abuse Prevention and Treatment Act of 2011 (now updated to 2012) addresses prescription drug abuse by: 1) Recommending mandatory education for providers before they
can be licensed to prescribe controlled substances; 2) Educating consumers on the safe use of painkillers and preventing
of diversion and abuse; 3) Using basic clinical guidelines for
safe use and dosage of pain meds including Methadone; 4)
Increasing federal support for state drug monitoring programs
and; 5) Improving opioid death registries.
Similarly, the 2011 Prescription Drug Abuse Prevention
Plan, an extension of the Obama Administration’s National
Drug Control Strategy, includes an emphasis on consumer
and provider education, implementing state prescription drug
monitoring programs, facilitating safe and proper disposal of
medications and enforcing stricter law and legal actions to
eliminate improper prescribing practicing and mill mil operators. Numerous legislative initiatives are underway in state and
local governments as well. As we seek to find solutions, all
parties must consider the balance between drug control and
appropriate pain management.
As the legislative process continues to unfold, the nation
stands to benefit from the Secure and Responsible Drug Disposal Act of 2010. President Obama signed this into legislation
fall of 2010 as part of the Administration’s efforts to combat
prescription drug abuse. Briefly, this legislation provides consumers with a means to dispose of unused and expired medications at a safe designated place at select times during the
year. Referred to as National Take Back Days, the next National
Take Back Day is scheduled for April 28, 2102 from 10am 2pm. Since the inception of these events the DEA, and its state,
local, and tribal law-enforcement and community partners
have removed 995,185 pounds (498.5 tons) of medication from
circulation in the past 13 months.
Combating prescription drug abuse should be everybody’s
business. The current epidemic is impacting urban and rural
communities nationwide. Our various chapters and members
are well positioned to provide patient and community education on the safe use and disposal of prescription drugs as well
as promote the national take back initiative. For detailed information and related locations, members are encouraged to visit:
http://www.deadiversion.usdoj.gov/drug_disposal/takeback/
index.html
References
National Institute of Drug Abuse (NIDA). (2011). Prescription drug
abuse and addiction. Retrieved from http://drugabuse.gov/PDF/
RRPrescription.pdf
Substance Abuse and Mental Health Services Administration
(SAMSHA) (2010).
Results from the 2009 National Survey on Drug Use and Health:
Volume I. Summary of National Findings (Office of Applied Studies,
NSDUH Series H-38A. HHS Publication No. SMA 10-4856Findings) Rockville, MD. Retrieved September 6, 2011, from http://oas.
samhsa.gov/nsduhLatest.htm
NBNA.org — 21
A Reflective Look at Practical Nursing
Ottamissiah Moore, President, National Federation of LPN; NBNA Life Time Member
O
ver 26 years ago, I stood with a group of my peers
in a crisp white uniform, holding a nightingale lamp.
It was my graduation from License Practical Nursing
(LPN) school and my entrance into the nursing profession.
Armed with my new license, a new nursing venture and a great
mentor, I was preparing myself for best career of my life.
The past
When I look at the history of practical nurses, some contend
it began in 1897, with the programs at Massachusetts General
Hospital in Boston, and New Haven Hospital in Connecticut
which opened around 1873. Others believe LPN practice started with the programs established in New York. These “trained”
nursing schools were Bellevue Hospital in New York City, the
Ballard School in New York (1893) (Anderson, 2001, p. 17); and
a training program for practical/vocational nurses developed
by the American Red Cross (1892) at the Young Women’s
Christian Association in New York City. After the turn of the
century, LPN education and licensure became more formalized
with the opening of the Thompson Practical Nursing School in
Vermont in 1907 and the Household Nursing School in Boston
in 1918 (White & Duncan, 2001).
World War II brought the need for additional nurses, which
focused attention on the contributions of the LPN/LVN. The
“Practicals” were licensed through waivers and different States
had different ways. Some required a letter of recommendation
from a physician, a supervisor, etc., and the nurse had to have
worked as a practical nurse for at least five years immediately
prior to application. State-by-State, they were waived into nursing. Their licenses had a “W” on it and for many of them it was
a stigma until they actually took the licensure exam. By 1945,
19 states and one territory had licensure laws. One state was
permissive licensing.
The National Federation of License Practical Nurses
(NFLPN) was organized in 1949 to provide a structure at the
national level through which LPNs and LVNs (Licensed Vocational Nurses) could promote better patient care and to speak
and act on behalf of the occupational group. It is the only organization in the United States governed entirely by LP/VNs
for LP/VNs. NFLPN is recognized by the other national nursing
organizations as the official voice of LP/VNs.
The Present
The discussion about the “phasing out” practical nurses
has been going on for more than 26 years. Although the conversation is quietly spoken, practical nurses are slowly leaving
areas they have practiced in for many years. Licensed Practical/ vocational Nurses across the county are voicing their concern over several issues as discussed below.
The underutilization of practical nurses, in some states and
workplaces, prohibits practical nurses to perform tasks that
they have been taught, and show knowledge, skill and competency to perform. LP/VNs are being replaced by unlicensed
assistive personnel. During periods of nursing shortage, LP/
VNs are often recruited for positions
which were originally RN jobs and
assistive personnel are often recruited for jobs traditionally held by LP/
VNs. While they can assist with tasks
associated with the maintenance
and support of the aged, they do not and cannot replace the
LP/VN at the bedside. While we may not be able to conduct
comprehensive assessments of the patient, we do understand
patient response, we have been taught how to conduct general assessments and able to accurately convey patient status,
care concerns and needs in a manner unknown to unlicensed
assistive personnel.
LP/VN students are not receiving the education and career
opportunities previously afforded the profession. Clinical experience has always been an integral part of nursing education. It
prepares student nurses to be able to perform as well as have
knowledge about the clinical principles in practice. Clinical
practice stimulates students to use their critical thinking skills
for problem solving. There is a strong demand for high-quality,
cost-effective clinical education experiences that facilitate student learning in the clinical setting. The clinical learning environment (CLE) is the interactive network of forces within the clinical
setting that influence the students’ clinical learning outcomes.
We believe clinical experiences would improve the knowledge,
skills and abilities of LP/VNs. We have heard about problems
existing with students obtaining clinical experiences, preceptorships, and job placement. No studies have been conducted
on this issue. Concerns about lack of clinical experiences for
LP/VN students may be one of the barriers to the NCLEX pass
rate and employment opportunities.
The Future of practical nursing
It appears there are more questions than answers. The
practice, the market and the education of LP/VNs is changing
every single day. The questions are…
How will LP/LVN become educated?
Who will offer clinical sites to LP/LVN students?
What will the skill set of an LP/VN look like over the next 10
years?
How will practical nurses transition to another position if the
market does not utilize them?
Who will precept LP/VNs new to practice?
These questions and others about the issues are endless.
Leadership in nursing must take a look at what part LP/VNs
have in nursing history, bedside nursing, patient outcomes and
work together to carve out a role and practice specifically for
LP/VNs now and for the future. Leadership must be creative
in our thinking to assist LP/VNs to transition to the role of an
RN. The nightingale light of LP/VNs is still shining. Given the
opportunity, LP/VNs will prove the value of practical nursing in
the primary, preventive and long-term care settings. We only
need to have our light shine brighter.
22 — NBNA.org
NBNA Strategic Plan at a Glance
Keneshia Bryant, PhD, RN, FNP-BC
Little Rock Black Nurses Association of Arkansas
NBNA Board Member/Lifetime Member
I
n order for any organization to be successful, each
member should know and understand the organization’s
strategic plan and work towards obtaining its goals. A strategic plan is the process of determining an association’s longterm goals and then identifying the best approach for achieving
those goals. The mission of NBNA is to “represent and provide
a forum for black nurses to advocate for and implement strategies to ensure access to the highest quality of health care for
persons of color.” Based on this mission the NBNA 2011-16
Strategic Plan contains seven goals. Below is an overview of
each goal.
Goal 1: Membership – Enhance and maintain a viable
membership that can fulfill and sustain the mission and goals
of NBNA.
There is power in numbers and in order to fulfill the mission
of NBNA, a growing active membership is vital. Membership
recruitment and retention are the key elements of the membership goal. The membership recruitment objectives are to:
1) develop a comprehensive recruitment campaign; 2) identify
and eliminate barriers to recruitment; and 3) increase visibility
at Historically Black Colleges and Universities and key nursing organizations. For membership retention the objectives
are to: 1) develop and implement effective retention plan and
strategies; 2) increase and enhance member services; and 3)
maximize chapter benefits.
Goal 2: Leadership – Promote NBNA as a global health
care leader.
The growth and advancement of the NBNA membership to
become global nurse leaders is the basis for this goal. The strategic plan includes the development of a leadership track for
members which includes leadership programs and institutes.
Additionally the plan is to establish and maintain collaborations
and networks with other professional organizations for leadership development.
Goal 3: Health Policy – Maintain and strengthen the organization’s capacity to influence health policy.
The purpose of this goal is to: 1) promote NBNA’s position
on health policy issues. This will be done by the development
of an annual national health policy agenda and increasing the
number of skilled health policy nurse leaders; 2) seek and
support membership appointments to policy, regulatory, and
governmental committees; 3) strengthen the ability of chapter members to shape national health policy that is based on
local issues; and 4) to provide support to international health
policy students. The expected outcomes for this goal are to
strengthen the ability of NBNA chapters, board members, and
chapter members to shape national health policy that is based
on local issues.
Goal 4: Program Development – Establish and maintain
a comprehensive NBNA program agenda.
Programs are often the key to establishing community
partners, promoting health and wellness, and diversifying the
workforce. Therefore, NBNA is dedicated to health promotion,
health protection, and disease prevention programs. Examples
of these programs include: The obesity initiative; the identification of annual health goals; participation in international health
conferences; and providing annual educational scholarships.
Goal 5: Research – Establish and maintain, in collaboration with the National Black Nurses Foundation, a NBNA
research agenda that promotes the community’s ability to
promote health.
Through this goal, NBNA will prioritize research activities,
which leads to the increased body of knowledge about health
care needs of African Americans/Blacks and other minorities, effective health care delivery systems for minorities and
the utilization of nursing services. Additionally, identify funding
sources to promote and support nursing research.
Goal 6: Sustainability – Improve and sustain the organization’s financial stability.
The strategic direction for this goal is to develop a secure a
financial base for operating expenses and budgeting for marketing campaigns, in addition to increasing the organization’s
overall revenue.
Goal 7: International Health – To establish NBNA as a
partner in global health care.
The desired outcome for this goal is to promote a dialogue
around nursing education practice as it relates to global health.
In addition, distinguish global health issues as they relate to
local policies. These goals will be achieved by collaborating
with NBNA members in the Caribbean, conducting forums
focused on nursing education issues, and highlighting global
health issues.
Each member has a responsibility to be active in the fulfillment of the NBNA strategic plan. Without the support of the
membership the goals cannot be obtained. Therefore, a member’s charge is to identify the areas they would like to support
and strengthen to move the organization towards its desired
outcomes.
Dr. Keneshia Bryant is an Assistant Professor and Translational Research Institute KL2 Scholar at the University of Arkansas for Medical Sciences in Little Rock, Arkansas.
NBNA.org — 23
Leadership... Are You a Leader?
Beulah Nash-Teachey, PhD, LTC (Ret), RN
I
s leadership learned or are you born with the gift? It
can be both. My first response to the question is, it a gift
from God. I truly believe God has given individuals very different attributes that can only be explained as a gift. Thus, in
this short article, I will discuss some general applications to
leadership, my growth and development in the military and list
Bass Theory (the leadership guide I use when helping young
military officers).
In life’s journey we choose to lead and in other circumstances we are forced into a leadership position. In either situation,
you must lead with passion and determination. How you lead
will determine how successful you will be and how those who
follow you will remember you.
Leadership literature and research has repeatedly confirmed that most of the time we lead by example. If you expound on procedures or techniques that you do not follow or
demonstrate, those who follow you will probably fail. Then the
question is what happened, why is this situation failing? The
answer most likely will reflect badly on you as the leader. Being
able to stand the test of leadership requires an individual to live
by what you teach.
My mentor echoes. “Leaders must accept each opportunity to lead and always do your best.” Brian Tracey (leadership
guru) suggest that a leader should read at least one hour every
day, be committed to learning for life, embrace every opportunity to lead, and learn to listen.
Being a leader, weather a gift from God or if you are thrust
into the position, serving in the military will soon put most individuals on the right path. As an Army Nurse Corps Officer for
over 27 years, it has given me a wide view of leading, mentorship, and how to govern. I have pondered the question, “Am I a
leader?” Leadership is defined in many different terminologies.
I view leadership as the ability to influence others to complete
the mission, no matter how hard the task may be. Striving to be
a great leader has been my center of growth and development
as a nurse and Staff Officer.
Commanding troops and being responsible for their safety
requires knowledge, will power, understanding your surrounding and having a no none sense attitude. However, of all the
traits that have been identified in leadership, the ability to first
follow is very important. Being able to motivate individuals to
move forward to complete the mission, although in a threat, is
always challenging.
Good leaders are developed through a process of selfstudy, education, training, and experiences (Jago, 1982). Bass
theory has helped me to develop and guide other military
officers.
Bass’ Theory of Leadership
Bass’ theory of leadership states that there are three basic
ways to explain how people become leaders (Bass, 1990). The
first two explain the leadership development for a small number
of people. These theories are:
n Some personality traits may lead people naturally into leadership roles. This is the Trait Theory.
n A crisis or important event may cause a person to rise to
the occasion, which brings out extraordinary leadership
qualities in an ordinary person. This is the Great Events
Theory.
n People can choose to become leaders. People can learn
leadership skills. This is the Transformational or Process
Leadership Theory. It is the most widely accepted theory
today and the premise on which this guide is based.
References
Bass, Bernard (1990). From transactional to transformational leadership: learning to share the vision. Organizational Dynamics, 18(3),
Winter, 1990, 19-31.
Jago, A. G. (1982). Leadership: Perspectives in theory and research.
Management Science, 28(3), 315-336.
Newstrom, J. & Davis, K. (1993). Organization Behavior: Human Behavior at Work. New York: McGraw-Hill.
Practical Nursing... continued from page 21
References
Blegen, M., Vaughn, T., Vojir, C. (2007). Nurse staffing levels: Impact of
organizational characteristics and registered nurse supply. Health
Services Research, 43(1), 154-173.
Larson, J. (2008). Are LPN jobs moving outside the hospital? Retrieved July 12, 2012, from http://www.nursezone.com/nursingnews-events/more-news/Are-LPN-Jobs-Moving-Outside-theHospital_26658.aspx
Magnet Doesn’t Attract Everyone found at http://www.afscme.org/
publications/4194.cfm
Lafer, G. & Moss, H. (2007). The LPN: A practical way to alleviate the
nursing shortage. Labor Education and Research Center, University of Oregon, for the United Nurses of America. Retrieved July 12,
2012, from http://www.afscme.org/news/publications/health-care/
the-lpn-a-practical-way-to-alleviate-the-nursing-shortage
Spector, N. (2005). Practical Nurse Scope of Practice White Paper.
National Council of State Boards of Nursing. Available at: https://
www.ncsbn.org/Final_11_05_Practical_Nurse_Scope_Practice_
White_Paper.pdf
24 — NBNA.org
Embracing the Challenge of Increasing Workforce
Diversity within the Nursing Profession
Clarise H. Ottley, PhD, RN
Faculty, Shepherd University, Department of Nursing Education
O
ver the course of many years, there have been
numerous campaigns launched in support of the need
to transform the nursing profession. One such campaign is Johnson and Johnson and the American Association
of Colleges of Nursing (AACN) Minority Nurse Faculty Scholars
Program, which was designed to increase the number of nurse
educators from underrepresented minority groups. The Institute of Medicine’s report (2010), The Future of Nursing: Leading
Change, Advancing Health, examined the nursing workforce
and how nurses can play a fundamental role in the support
of transforming the profession. Opportunities to advance the
nation’s health needs must not lose site of the challenge to
prepare a workforce that “mirrors the faces and values of those
who seek care” (Wilson, Sanner, & McAllister, 2010, p. 144).
The nation’s demographic population is changing. The
United States Census Bureau (2010) projects a decrease in the
number of Whites between 2010 and 2050, and an increase in
the Hispanic or Latino population. The population in the United
States is expected to reach 439 million by 2050, with a projection
that 82% of this increase will be largely due to immigrant families.
A report released by the Sullivan Commission (2004) on Diversity in the Health care Workforce indicated that the nation’s
health professions have not maintained the needed pace of the
changing demographics necessary to provide the kind of care
that is needed for the population it serves. The lack of diversity
in the nursing profession compared with the fast changing diversity in demographics may be a cause of disparities in health
access and outcomes (Sullivan Commission, 2004)
The lack of diversity in the nursing profession is believed
to be a result of the lack of minority nurse educators (AACN,
2001). There is a correlation between the number of minority
nurse educators and the number of minority nursing students
enrolled in nursing programs. Research indicates that a lack of
minority faculty is a barrier to the recruitment and retention of
culturally diverse nursing students (Zajac, 2011; Mills-Wisneski,
2005). AACN indicated that this need to attract diverse nursing
students is paralleled by the need to recruit more nursing faculty from minority populations. It is encumbered upon nursing
not only to actively recruit more minority nursing faculty, but
also to collaborate on ways to retain them. Creative strategies
must be developed that will provide both.
Mentoring of nursing faculty is one strategy that researchers have identified as key to recruitment and retention. The
National League for Nursing (2006) indicated that mentoring as
a strategy, will help recruit and retain qualified nurse educators
because it helps establish healthful work environments. Mentoring, defined as one-to-one reciprocal relationship between a more experienced and knowledgeable faculty member
and a less experienced one, characterized by regular/consistent
interaction over a period of time to
facilitate the mentee’s development
(Haggard, Dougherty, Turban, &
Wilbanks, 2011), is necessary for job
satisfaction and faculty retention
According to authors Wroten and
Waite (2009), in addition to guidelines for effective mentoring, the impact of race as a salient
factor in development of mentoring relationships should not
be overlooked. Both cross-race and same-race mentoring
relationships provide career support for the faculty member.
However, for minorities, whether nursing students or faculty,
same-race relationship mentoring provides an added psychosocial support when considering trust and attachment that
they may not find with cross-race mentoring.
The connection between the mentor and the mentee with
same-race mentoring is vital to attracting minority faculty and
students. Hubbard (2006) indicated that the most persistent
and statistically significant predictor of enrollment and graduation of an African American graduate student is the visible
presence of an African American faculty member. A barrier
for this type of effective mentoring is the small pool of minority
faculty who are in a position of leadership that can mentor other
minority faculty and minority students.
In supporting the changing face of nursing, so that it is
more reflective of a diverse profession and the current population, the establishment of opportunities for mentoring of minority faculty is a priority. There must be a commitment to increase
diversity in nursing by actively recruiting minority faculty, and
providing them with the environment that nurtures and supports them along each of their continuum. The belief is that
visible nurse educators will send a signal to potential nursing
students that nursing values diversity, and encourages support
through same-race mentoring.
Dr. Clarise Hairston Ottley, a recent protégé in the National League for Nursing/Johnson & Johnson Faculty Leadership and Mentoring Program, is a faculty member at Shepherd
University in the Department of Nursing Education. She received a bachelor of science degree from North Carolina Central University in 1977, an associate of science in nursing from
Shepherd in 1991, a master of science from George Mason
University in 1997, and a Ph.D. in nursing from Duquesne University in 2009. In addition to being an academician, Dr. Ottley
is a certified nurse specialist, specializing in maternal/newborn
care, and a certified childbirth educator, licensed to teach
childbirth education/Lamaze classes.
A Helping Hand
NBNA.org — 25
Edward M. Rogers
W
hen a person thinks of a hotel they would never
associate it with a hospital. Indiana University Health
Methodist Tower Inn provides housing for patients
throughout the world who come see the best doctors. Not only
does the Methodist Tower house potential patients, but in addition families come from all parts of Indiana and throughout the
country to visit a loved one or friend at Indiana University Health
Hospital in Indianapolis, IN.
Doctors, nurses, and other employees also have the ability
to obtain rest while on-call without having to travel back from
home and work. Being in a hospital for hours without any rest
or a place to stay can be very stressful to a person who is not
from the city of Indianapolis. The best solution when a person
has a loved one in the hospital is always being by their side.
That feeling of guidance and protection to the patient can help
no matter what is going on with their health condition.
Always trying to be there for someone when you’re not from
that area can be hard on an individual and can come with an
expensive price. Indiana University Health has created a concierge program to give families a place to rest without draining
their wallets during a time when they have to take care of a
family member. Having the comfort of being by a sick loved one
gives the family relief that they can be by their side when the
patient needs them.
The Indiana University Methodist Tower Inn started around
1980 as on the twelfth floor providing rooms for transplant
patients. Indiana University Methodist Tower Inn now operates
between 66 to 86 rooms on a daily basis filled with those who
have some association with the hospital. Accommodations
are very suitable and pleasant. The Methodist Tower provides
transportation to other area Indiana University Health hospitals. Housekeepers are staffed to clean and also provide any
service needed to the family at that time. The Methodist Tower
provides free laundry services to those who are guest and
those who have been staying within the hospital. In addition to
laundry services, the Methodist Tower provides public showers
to individuals who are not guests at the hotel, but who have
been staying in the hospital with a patient. This service is good
for families to know that the hospital can assist with any problem one may encounter.
Accommodating those who are visitors to a patient in the
hospital is a good idea for Indiana University Health to implement. The feeling of being treated like you’re important to them,
which you are, can go a long way emotionally when someone
is in the time of need. Be glad to know that those employees,
doctors, and nurses will do everything possible to make you
feel welcomed. I’m glad to say that I’m proud to have experienced an organization that empathizes with people in adverse
situations.
diversity continued from page 24
References
American Association of Colleges of Nursing (AACN), (2011) Statement of Diversity and Equality of Opportunity. Retrieved May 7, 2012
from the AACN Website: http://www.aacn.nch-e.edu/publications/
positionss/diverse.htm
American Association of Colleges of Nursing. Fact Sheet: Enhancing
diversity in the nursing workforce. Retrieved from http://www.aacn.
nche.edu/media-relations/diversityFS.pdf
Haggard, D., Dougherty, T.W., Turban, D.B., Wilbanks, J.E. (2011)
“Who is a mentor? A review of evolving definitions and implications
for research,” Journal of Management, vol. 37, 280-304
Hubbard, D., (2006). The color of our classroom, the color of our
future. Academe, 92(6), 27-29.
Institute of Medicine (2010).The future of nursing: Leading change,
advancing health. Retrieved May 10, 2012 from the IOM website
report: http://www.iom.edu/Reports/2010/The-Future-of-NursingLeading-Change-Advancing-Health.aspx
Mills-Wisneski, S. (2005). Minority students’ perception concerning
the presence of minority faculty: Inquiry and discussion. The Journal of Multicultural Nursing & Health, 7(2), 49-55.
National League for Nursing (2006). Statement: Mentoring of nurse
faculty. Nursing Education Perspectives, 110-113.
Sullivan Commission on Diversity in the Health care Workforce, “Missing Persons: Minorities in the Health Professions,” 20 September
2004, http://www.jointcenter.org/healthpolicy/docs/SullivanExecutiveSummary.pdf (accessed 8 May 2012); http://www.aacn.nche.
edu/Media/pdf/SullivanReport.pdf
Wilson, A.H., Sanner, S., & McAllisteer, L.E. (2010). An evaluation study
of a mentoring program to increase the diversity of the nursing
workforce. Journal of Cultural Diversity, 17(4), 144-150.
Wroten, S.J., & Waite, R., (2009) A call to action: Mentoring within the
nursing profession - a wonderful gift to give and share. Association
of Black Nursing Faculty Journal. 106-108
U.S. Census Bureau (2010). Census 2010 Population distribution in
the United States and Puerto Rico; http://www.census.gov/geo/
www/maps/2010_census_nighttime_map/nighttime_map_2010.
html
Zajac, L. (2011). Double-loop approach: Recruitment and retention of
minority nursing faculty. Association of Black Nursing Faculty Journal. Summer 2011.
26 — NBNA.org
Raise the Voice!
Joanne Disch, PhD, RN, FAAN
“H
ealth care in America today is inaccessible
to many, expensive for most and fragmented for
all.”1 In January 2012, the Institute of Medicine published Living Well with Chronic Illness: A Call for Public Health
Action2, outlining the ‘epidemic’ of chronic disease which represents 75% of the $2 trillion spent annually on health care.
The report emphasized the numerous determinants affecting
health, such as genes, biology, behavior, coping responses,
the role of peers and family, the social-cultural context, and the
physical environment. None of this is new to us as nurses: We
have always worked with the patient in the context of the family,
environment, community and socioeconomic considerations.
In fact, while health care systems have created monumental
structures that perpetuate the physician-dominant, acuityoriented, hospital-based care model evident today, nursing
innovators have quietly gone about developing new models
of care that are cost-effective, personalized, convenient and
successful in helping individuals and families deal with chronic
illness. Perhaps too quietly.
This is why the American Academy of Nursing, under the
leadership of then-president Linda Burnes Bolton, launched
the Raise the Voice! campaign to educate the public and
policymakers about the creative approaches that nurses are
taking to assure that people, often the under- and un-insured,
receive the care that they need and minimize the complications of chronic disease. Over the past six years, 49 nurses
have been identified as Edge Runners, or practical innovators
who have developed new care models that achieve significant
clinical and financial outcomes. Here are profiles of a few Edge
Runners and their work:
n 11th Street Family Health Services is a community-based
center that provides access to not only clinical services but
to a wide range of health promotion and disease prevention
services to inner-city Philadelphia residents. Employing a broad
trans-disciplinary team of health professionals, it also has
a strong educational and research component, serving as a
clinical site for many health professions’ students. In addition
to more than 25,000 clinical visits, it has made 1650+ home
visits to pregnant or new mothers, and thousands of wellness
and health encounter sessions. In 2011, the center reduced
pre-term births to 2.5% in African American for their women,
compared to 15.6% in the city. (Patty Gerrity, PhD, RN, FAAN)
n The St. Francis Health Center improves access to quality primary health care services for the poor and uninsured,
integrating both physical and mental health assessment,
treatment and follow-up services, regardless of employment
status or income. Founded and managed by a team of nurse
practitioners and clinical nurse specialists in Joliet Il, they use
weekly team meetings to discuss case management and approaches to care. Their patient base includes place-bound elderly and disabled, victims of domestic violence, the working
poor and uninsured. Since their opening, they have provided
services to more than 6,500 patients. They offer services
daily, with some evening hours and
weekend coverage by NPs. (Carol
Jo Wilson, PhD, RN, CNP)
n INSIGHTS help parents and
teachers recognize children’s temperaments so that they can deal effectively with minor behavioral problems, help them learn self-regulation strategies
and enhance their interpersonal relationships with families,
teachers and friends. This 10-week intervention, developed in
partnership with African American and Hispanic community
members, has helped children with ADHD without using medication, reduced the behavior problems of children with serious
disruptive behaviors, enhanced parents’ ability to handle their
children’s behavior; and reduced aggressive behavioral episodes in the classroom. (Sandee McClowry, PhD, RN, FAAN)
The Academy website (http://www.aannet.org/raisethevoice) offers details on these innovators and other Edge Runners. Also on the website are the criteria for becoming an Edge
Runner. Consider applying for this designation or nominating
colleagues if you or they have developed an innovative care
model that has made a measurable difference in health care
outcomes. Nominees need not be Fellows in the American
Academy of Nursing. Here are the criteria:
n Nominations support the innovative work of nurses and
demonstrate the holistic and integrated philosophy underlying nursing care.
n The nomination demonstrates how an innovative solution (intervention or model of care) remedied a problem in
the delivery of health care or an unmet health need of a
population.
n Although single demonstrations are acceptable, data that
substantiate the success and impact of the project must be
included with the nomination.
n There is evidence that the original work has been replicated
or has the promise of leading to replications in other settings.
In conclusion, nurses have historically understood what the
public wants from health care, and have generated creative solutions for delivering it. It’s time to showcase the important work
that nurses are doing, and Raise the Voice! on the significant
contributions that nurses are making to achieve a reformed
health care system.
Dr. Joanne Disch is a Clinical Professor and Director
of the Katharine J. Densford International Center for Nursing
Leadership, and the Katherine R and C Walton Lillehei Chair
in Nursing Leadership at the University of Minnesota School of
Nursing. She is currently the President of the American Academy of Nursing.
References
1. American Academy of Nursing (2011). Edge Runners. Retrieved
February 25, 2012 from http://www.aannet.org/edgerunners.
2. Institute of Medicine (2012). Living well with chronic illness: A call for
public health action. Retrieved February 25, 2012 from http://www.
iom.edu/~/media/Files/Report%20Files/2012/Living-Well-withChronic-Illness/livingwell_chronicillness_reportbrief.pdf.
NBNA.org — 27
Parliamentary Tidbits: Your Role Has Been Cast
Azella C. Collins, MSN, RN, PRP
O
rganizational presidents are dependent upon
many individuals; committee members, committee
chairmen, officers both elected and appointed. Most
members are probably more familiar with the duties of the secretary than with other officer because the secretary is more
visible in the performance of duties during meetings. According to Robert’s Rules of Order, Newly Revised, 11th Edition,
(RONR), the secretary, “is the recording officer of the assembly
and custodian of its records, except those specifically assigned
to others...” There are eleven duties listed for the secretary on
pages 458-459 of RONR. If you are a secretary, make sure you
read the list as well as your organization’s bylaws. The secretary should be an individual who is organized and detailed
oriented. Minutes should be prepared promptly after a meeting when the details are fresh. The secretary should make a
list of tasks to be completed after a meeting and check them
off as they are completed. Additional duties are listed in The
Complete Idiot’s Guide to Robert’s Rules, by Nancy Sylvester.
In organizations where there is more than one secretary, the
bylaws should specify the duties of each position.
Many people think that the treasurer is the most important
officer. RONR page 461 states, “The treasurer of an organization is the officer entrusted with custody of its funds. The
treasurer, and any other officers who handle the organization’s
funds, should be bonded for a sum sufficient to protect the
organization from lost.” The duties of the treasurer will vary depending upon the size of the organization and the complexity
of its finances; but this officer cannot disburse funds except
by authority of the organization or as the bylaws so prescribe.
Once the board or members have adopted the budget, it is the
treasurer’s responsibility to make sure the organization spends
within the established budget. It is important for the treasurer to
keep accurate records and to make deposits and promptly pay
bills. When writing checks, the treasurer should use a gel pen,
which is more difficult to ‘wash’ than ballpoint pens. The treasurer is required to make a full financial report as prescribed by
the bylaws or rules. The treasurer’s report should include, but is
not limited to: balance on hand at the beginning of the reporting
period; all income; all disbursements; and balance on hand at
the end of the reporting period. This report is for information
only and is never adopted, but filed pending audit. For organizations with annual expenses of less than $50,000, an internal audit can be conducted by financial savvy members who
are not officers or committee chairmen. The Complete Idiot’s
Guide to Robert’s Rules page 224, provides a list of items that
must be available for internal and or external auditors. If your organization has grants and/or monies from various foundations
a Grant and Finance Committee Procedure Manual is needed.
The vice president—the understudy for the president—
stands in the wings, prepared to fill in at the last minute or
assume the position permanently if the president is unable
to continue in the office, and many think that this is the most
important office. “A vice president should always be prepared
to take over for the president. Some ways of doing that include
discussing with the president the
agenda before each meeting; having
an agenda, the bylaws, and parliamentary authority for all meetings;
and arriving at the meeting early
enough to be prepared for the start of the meeting. If a vicepresident prepares in that manner, then in an emergency that
delays the president, attendees won’t have to sit around wasting time waiting for the president. The vice president can start
the meeting on time.” (Sylvester, page 23). In organizations
where there is more than one vice-president, the bylaws should
specify the duties of each position.
RONR page 462 devotes four lines to describing the duties
of the historian, in the opinion of this writer the historian is the
most important officer. The historian prepares a narrative account of the organization’s activities during his or her term of
office, which, when approved by the assembly, will become a
permanent part of the organization’s official history. The principal duty of the historian is to keep a continuous, systematic
written record in chronological order of significant historical
events and activities, for the term of his office. Most organizations require the historian to have other duties and responsibilities in addition to compiling a written history. Some organizations require the historian to keep a scrapbook or file of
newspaper and publicity notices, pictures, reports, yearbooks,
workshops, seminars Christmas brunches, etc. and other historically significant material.
In the age of computers, the reports should also be saved on
a CD or memory card. Unfortunately, many organizations lose
their history when a member dies and leaves no instructions for
the family about what to do with the organization’s material.
Committee chairpersons must obtain minutes of previous
committee meetings, review annual reposts, newsletters, and
member surveys if applicable. Their principal duties should be
outlined in the organization’s bylaws. The chairpersons must
be the most knowledgeable person in the group. Plan the
meeting, have an agenda ensure each member knows what
business is being considered by discussing one item at a time.
Allow for adequate discussion (when committee members
begin to repeat issues tactfully limit discussion and bring the
issue to a vote). Keep a list of action items and check them off
as they are completed.
The most important people in any organization are the committee members who must understand their overall tasks and
specific role. Majority rules: if you were not on the prevailing side,
work hard to ensure group success, do not be a poor loser. You
are the workhorses of all organizations. What role in the cast
will you play? How do you prepare to fulfill your duties and responsibilities? How will you support your organization? Abigail
Adams once stated, “Learning is not attained by chance. It must
be sought for with ardor and attended to with diligence.”
References:
1. Robert’s Rules of Order, Newly Revised 11th Edition.
2. Sylvester, Nancy. The Complete Idiot’s Guide to Robert’s Rules.
28 — NBNA.org
MEMBERS on the MOVE
NBNA President’s Photo Highlights
LEFT: Dr. Deidre Walton meets with Kathleen R.
Fogarty, Hospital Director and Laureen Doloresco,
MN, RN, NEA-BC, Associate Director, Patient Care/
Nursing Service/CNO at the John Haley VA Medical
Center in Tampa, FL.
ABOVE: Dr. Deidre Walton, NBNA President,
with Dr. Ruth Caggins, BNA of Greater Houston
President, Yvonne Olusi, RN, FBCBNA President,
and Lola Denise Jefferson, NBNA 2nd Vice
President at the Fort Bend County Black Nurses
Association’s 11th President’s Scholarship &
Awards Ball
LEFT: Dr. Walton, NBNA President, with members
of the National Black Nurses Tampa Bay, Inc.
Dr. Walton, NBNA President,
with members of the Tampa
chapter of NBNA.
MEMBERS on the MOVE
NBNA.org — 29
San Diego Black Nurses Association, Inc. (SDBNA)
Michael Deangelo Jackson, RN, has been appointed to
the California Board of Registered Nursing by Governor Jerry
Brown. Jackson has been a clinical nurse II in the Department
of Emergency Medicine at the University of California, San
Diego Medical Center since 2000. He has been an adjunct
clinical faculty member in the registered nursing program at
Southwestern Community College and an operations supervisor at Scripps Mercy Medical Center since 2007.
Jackson was a mental health worker at Scripps Mercy
Medical Center from 1992 to 2000. He served as a lance corporal in the United States Marine Corps Reserve from 1989
to 1993.
San Diego Black Nurses Association, Inc. hosted its
Annual Prayer Breakfast on Saturday, December 10, 2011 at
Bayview Baptist Church Martin Luther King Auditorium. The
theme was, “Hear Me While I Pray.”
The late Yvonne Hutchinson, RN, past SDBNA President and NBNA Board member, originated the Annual Prayer
Breakfast concept in the 1980’s. Initially, the event occurred in
the homes of SDBNA members, but it has since grown exponentially. The December 10, 2011 attendance of 260 guests
was the largest attendance since inception of the Annual
Prayer Breakfast.
The primary focus of the Annual Prayer Breakfast is to
demonstrate SDBNA’s appreciation of the organization’s many
supporters, friends, and collaborators. During the program
SDBNA members expressed appreciation to guests for their
continued support to our organization. Gifts were given to
guests as tokens of appreciation. Guests’ were also given the
opportunity to express their appreciation to the organization for
their indefatigable efforts to decrease disparities in the community. Sharon Smith, RN, SDBNA President, presented
Dr. Deidre Walton, NBNA President, with a gift from Kenya
which she acquired on a humanitarian trip in 2011 with two
other SDBNA members, Rose Jones and Shenell Baker.
Dr. Walton was the keynote for the event. She spoke passionately about health issues in African American and underserved communities and the importance of prayer in our lives.
We were challenged to actively combat health issues individually and as a community.
Dr. Irene Daniels-Lewis, NBNA Treasurer, was in attendance. She serves as the Chapter Liaison and is a member
of the San Jose Black Nurses Association. Dr. Daniels-Lewis
expressed encouraging and heart-felt remarks that SDBNA
members and guests appreciated.
Dr. Walton attended church services with SDBNA
members at Bayview Baptist Church. Pastor Timothy J.
Winters introduced Dr. Walton to the Bayview congregation
where she received a warm welcome. Dr. Walton had lunch
with SDBNA members after church before departing to her
home in Scottsdale, AZ. The weekend of memorable events
with Drs. Walton and Daniels-Lewis were highlights of a successful and productive year for the San Diego Black Nurses
Association, Inc. under the capable leadership of Sharon
Smith, SDBNA President.
Birmingham Black Nurses Association (BBNA)
Deborah Andrews. MSHSA, RN, President of BBNA
has been invited to serve on the Alabama Advocacy Subcommittee for the American Heart Association/ American Stroke
Association.
At BBNA’s monthly meeting on Monday night, March 19,
2012, Tamara Marshall MD, Clinical Science Manager for
Abbott Renal Care presented, “Health care disparities: An
associated link between chronic kidney disease & cardiovascular disease.”
Dr. Jennifer Coleman, President-elect presented a
podium presentation entitled, “The Power of Simulation in
Pediatrics: Effect on Confidence & Clinical Reasoning Skills”
at Drexel University annual simulation conference. The conference title was Simulation in Health care: Where No One Has
Gone Before and was held in Fort Lauderdale, Florida on
March 20-23, 2012. Conference sponsor was Drexel University
College of Nursing & Health Professions, Division of Continuing
Nursing Education.
Deborah Andrews, BBNA President, Candace Grimes,
Deborah Thedford-Zimmerman and Carthenia Jefferson, JD, RN, attended the American Heart Association, Heart
Walk Executive Leadership Breakfast on March 7, 2012 at
Vulcan Park and Museum in Birmingham. BBNA will be raising
funds and walking in the AHA Heart Walk on June 30th.”
The National Tuskegee Airmen Scholarship Foundation,
the Atlanta Tuskegee Airmen, Inc. Chapter and VITAS Innovative Hospice Care of Atlanta, hosted a Gold Medal Luncheon
Tribute to the Tuskegee Airmen. The Red Carpet Affair was
held on Saturday, March 31, 2012 in Atlanta, Georgia in recognition and honor of the 5th Anniversary of the Tuskegee Airmen
receiving the Congressional Gold Medal. This national event
was held around the country to raise awareness and provide
support to the Tuskegee Airmen Scholarship Foundation’s
continuing mission to assist financially disadvantaged and deserving students in pursuit of their college education. Deborah
Andrews, president of BBNA, Deborah Thedford-Zimmerman
and Marcia Lowe, MSN, RN, attended the event. The Birmingham Chapter received a gold medal award plaque for outstanding contribution. Nurses from Birmingham, Atlanta and
the Tuskegee areas received Gold Medal replicas of what the
Tuskegee airmen received. Dr. Holeman, Dean of Tuskegee
University School of Nursing brought greetings on behalf of the
President, Dr. Gilbert L. Rochon.
30 — NBNA.org
MEMBERS on the MOVE
Birmingham BNA Nurses: Impacting the HIV Epidemic with Education
On February 11, 2012, Birmingham Black Nurses Association was represented by Estella Woods, RN, and Kim
Rutley-Campbell, RN. These nurses conducted a Basic
HIV Nursing “Train-the-Trainer” Program at the University of
Alabama at Birmingham Hospital. The initial class for Birmingham, AL was held on November 4, 2011. Each attendee was
provided with a flash drive of tools to facilitate their commitment
of training ten additional nurses and then provide them with the
same flash drive of tools to facilitate training other nurses, and
as many people in their communities as possible. This training,
sponsored by the Association of Nurses in AIDS Care (ANAC),
was funded by the Elton John AIDS Foundation (ELAF) to train
non-HIV specialist nurses in Alabama, Georgia, Tennessee,
Florida, and Louisiana. ANAC mission is to promote the individual and collective professional development of nurses involved
in the delivery of health care to persons infected or affected by
HIV. The goal of this “Train-the-Trainer” program is to expand
the number of nurses who are capable and willing to engage
patients on topics related to risk and infection with HIV. This
training was significant for nurses, considering the growing
epidemic in the African American Community and Southern
United States and given the fact that nurses frequently encounter patients at risk for or infected with HIV. Ultimately, as nurses,
we can provide a safe and therapeutic environment for HIV risk
assessment and education.
Birmingham Black Nurses Association Nurse Setting Trends as Certified
Transcultural Nurses:
On February 13, 2012, BBNA nurses Kim Rutley-Campbell, RN, Olivia Bahemuka, RN, and Sophia Posey, RN,
were part of a cohort of nurses nationwide who took and
passed the first pilot exam for the Transcultural Nursing-Basic
Certification (CTN-B). The exam was developed by an expert
panel under the Transcultural Nursing Certification Commission (TCNCC) in 2011 and will be fully implemented in 2012.
Certification in Transcultural Nursing demonstrates to nurse
colleagues, patients, employers, and others, the knowledge,
experience, and commitment to transcultural nursing. These
nurses have demonstrated themselves to be knowledgeable
and skilled transcultural nurses who are prepared to give
safe professional care to people of diverse cultural life ways
and accomplish quality research, teaching, practice, and
other related roles. Moreover, transcultural nursing certification validates the ability to provide culturally competent and
congruent care to clients, families, communities, and organizations. Lastly, this certification will assist the BBNA nurses
in understanding the history of their own African American
culture, African American health views, and their impact on
the health ways and health care of African Americans. Each is
challenged by the objective of “Each One Teach One.”
NBNA.org — 31
MEMBERS on the MOVE
Kim R. Rutley-Campbell, BSN, RN, CRRN,
CHPN, CTN-B, BA, MAE, CHES UAB
Palliative Care and Comfort Unit
Birmingham Black Nurses Association members attend the Birmingham
Heart Walk Executive Breakfast. Members, left-to-right: Carthenia
Jefferson, JD, RN, Candace Grimes, RN, Deborah ThedfordZimmerman, RN, and Deborah Andrews, MSHSA, RN, President BBNA.
NBNA meets NSNA Members
Jacinta Williams and Maisha Arnold
Attending the National Student Nurses’ Association Convention in Pittsburgh, Pennsylvania, we were elated to see the
National Black Nurses’ Association booth. We were impressed
with the passion Marcia Lowe, MSN, RN, NBNA Board
Member and Estella Lazenby, NBNA Membership Coordinator, had for the organization as they recruited new members to
join. The information provided on membership, programs and
events, scholarships, and involvement was very resourceful
and motivated us to share with our peers to encourage them
to join as well. We understand the importance of Black nurses
empowering one another for the betterment of quality health
care and addressing health disparities within our community.
For this reason, we are committed to joining the efforts of the
National Black Nurses Association in implementing strategies
that ensure access to health care equal to health care standards of society.
Jacinta Williams is a member of the Chicago Chapter National Black Nurses Association. She is currently a BSN student
and the Project Manager for the Student Nurses’ Association
at Resurrection University in Oak Park, IL and is expected to
graduate in May 2013.
Maisha Arnold is enrolled in the BSN program at Resurrection University located in Oak Park, IL. She is expected to
graduate in May of 2013. Maisha is currently serving as VicePresident for Resurrection University’s Student Nurses’ Association (RUSNA).
32 — NBNA.org
MEMBERS on the MOVE
NBNA meets NSNA Members (continued)
Estella Lazenby, Membership Services Manager for NBNA and NBNA
membership chairperson, Marcia Lowe, MSN, RN, NBNA Director, participated as vendors at the National Student Nurses’ Association 60th Anniversary
Convention & Alumni Reunion. The convention was held in Pittsburgh, PA, at
the David L. Lawrence Convention Center from April 11-15, 2012. The theme of
the convention was, “Spanning the distance: 60 years of the Evolving Nurse.”
This was the first time that NBNA had an opportunity to participate as a vendor.
Students from all over the United States participated in the conference and
visited the booth. Many of the students stated that they did not know there
was a National Black Nurses Association and many were curious to see how
they could become a part. Many received literature to take home to become
a member, how to start a chapter, and regarding the conference in Orlando,
FL. Students were encouraged to share the information with their fellow colleagues as well. Students who joined on site received a NBNA pin, backpack
or umbrella. Faculty of schools visited the booth and expressed an interest to
have their students become involved. One myth that was dispelled was that
students thought they had to be African American to join. Our participation in
this conference is the beginning of many efforts to ensure that NBNA is visible
among other organizations. So, here’s to a great partnership with the National
Student Nurses Association.
New York Black Nurses Association (NYBNA)
NYBNA is collaborating with one of our new members,
Courtney White, to work on a project to address obesity.
The project is in its early stage and is called Healthier Nurse
Campaign. It is a two part process influenced by Roy’s
Adaptive Model Theory to ascertain if the appearance of
an unhealthy nurse contributes to an ineffective adaption of
the patient: Data will be collected from both the nurses and
patients view-point, analyzed for any significant findings and
recommend changes/implementations to aid with effective
adaption. A four-phase weight-management program will be
implemented and run concurrently to support any collected
data.
The 24th Annual National Black Nurses Day Celebration
was held at the Hospital for Joint Diseases at NYU Langone
Medical Center in New York City. The theme was, “Nurses
Alleviating Global Health Crises.” Rev. Dr. Rose EllingtonMurray received chapter’s service award. Dr. Deidre
Walton, President NBNA was in attendance. Jackie
Rowe-Adams was the recipient of the Community Award.
Sponsors of the event included Theta Chi Chapter of Chi
Eta Phi Sorority, Inc., New York Black Nurses Association,
Inc., Queens County Black Nurses Association, Inc., Kappa
Eta Chapter of Chi Eta Phi Sorority, Inc. and the Caribbean
American Nurses Association, Inc.
NYBNA members attended the 24th Annual Black Nurses
Day on Capitol Hill: Bernice Headley, RN, Hayward Gill,
Jr., RN, Imani Kinshasa, RN, and Mirian Moses, RN.
Members of NYBNA attended the 9th Annual UFT
Heritage Committee Dinner Dance Members included Bernice Headley, Marcia Skeete, Jean Straker, Susan
Thompson (President), Jasmin Waterman and Jacquetta Miller Whaley, RN.
Mirian Moses, MS, RN, and Jacquetta Miiler Whaley,
RN, attended the NYU College of Nursing 21st Annual Estelle Osborne Recognition Ceremony. Miriam also attended
the National Black Nurses Celebration held by Chi Eta Phi
Sorority and Northern New Jersey Black Nurses Association
in Newark.
C. Alicia Georges, EdD, RN, FAAN, Nursing Education
Chair at Lehman College, was the keynote speaker at the
first MSN graduating class of Lehman College in partnership
with Bronx Lebanon Hospital. Dr. Georges was also honored as an “Exceptional Black College of Nursing Alumni” at
Seton Hall University in Orange, NJ.
Bernice Headley, RN, Miriam Moses, MS, RN,
Joyce Fowler, RN and Yvonne Plummer, RN, attend the
Hospital Auxillary Volunteer Achievement Award Ceremony
held at The Waldorf Astoria in NYC.
Etta White, RN, was honored at the National Action Network Women Auxiliary, NYC Chapter, 16th Annual “Woman
of Excellence and Man of Vision” Award Ceremony and
Luncheon. Etta also received the Philanthropic Award from
the North Bronx Section for assisting college students with
financial support. Etta was also presented with the Florence
Nightingale Award for Leading and Advancing the Profession
of Nursing by the James J. Peters Veterans Administration
Medical Center
Imani Kinshasa, RN, was honored at the Butler Memorial United Methodist Church 100th Anniversary Luncheon
Celebration.
MEMBERS on the MOVE
NBNA.org — 33
Council of Black Nurses, Los Angeles
(CBNLA)
South Eastern Pennsylvania Area Black
Nurses Association (SEPABNA)
Eric J. Williams DNP, RN, was appointed to the California
Action Coalition fun development committee. The responsibility of the coalition is to secure funding for the activities of the
coalition. Dr. Williams was a speaker at the Chi Eta Phi Southwest Regional conference. The theme was, The Importance
of Education for the Improvement of Quality Patient Care. The
IOM report and social determinants of health integration into
nursing curriculums was a major focus of the presentation. Dr.
Williams was selected by the Assembly of Men in Nursing to
serve as a mentor for a male nursing student in a Bachelor
of Science in Nursing program. This pilot program identified
twenty mentors and mentees across the United States to
participate in a year-long program prior to full implementation
of the program. Dr. Williams was also appointed to serve on
the board of directors of the Rainbow Academy Foundation.
The Academy offers a culturally relevant curriculum and serve
many economically disadvantage children. “Dr. Williams’ cultural competence background and educational leadership experience will complement the board’s mission and objectives,”
stated the president of the Rainbow Academy Foundation.
The founder of the South Eastern Pennsylvania BNA, Dr.
Lucy E. Yates, was among those who supported the Black
Women’s Health Alliance during an informational session with
Secretary of Human Services, Kathleen Sebelius, at the African American Museum, Philadelphia, PA. The focus was an in
depth testimony of the positive impact of the Health Care Act of
a variety of community members.
Denise Pinder, RN, Vice President SEPABNA, and Dr.
Yates conducted mental health screenings while collaborating
with the Chester Alumnae Chapter of Delta Sigma Theta Sorority in Oakeola, PA. This powerful workshop entitled, “My Cry in
The Dark” upholds the premise that mental health is real health.
As a part of Black History Month, Dr. Yates presented,
“Heart Healthy African American Women” for the Good Neighbor Senior Center, Darby Twp. PA. She also led a lively multifaceted health awareness discussion with the women of 2nd
Baptist Church of Media, PA.
Minie Murphy, RN, Treasurer SEPABNA, Gerri Yancey,
RN, and Dr. Yates participated in a Career Day event at the
Global Learning Academy Charter School, Philadelphia, PA.
Nevada Black Nurses Association
(NBNA)
Congratulations...
Congratulations to chapter member, Mary Derrickson
Johnson, RN, who resides in Palmer, AK, for successfully
completing a parish faith based program for registered nurses;
Juanita Jones, MS, RN, President SEPABNA, who graduated from the Master in Management program at GwyneddMercy College, Gwynedd Valley, PA; and to Karen King
Shannon, BSN, RN, Immediate past president SEPABNA,
who graduated from Gwynedd-Mercy College with a Bachelor
of Science in Nursing.
Memphis Riverbluff Black Nurses
Association (MRBNA)
Debra A. Toney, PhD, RN, FAAN, NBNA Immediate
Past President, was selected to serve as chair of the Nevada
Action Coalition. Dr. Toney was the speaker at the White House
African American Policy Forum. She presented on the topic,
“What the Affordable Care Act Means to African Americans:
Identifying Issues Critical to the African American community
and the nation.” Dr. Toney was also elected treasurer of the
RWJ Executive Nurse Fellows Alumni Association. Dr. Toney
was selected to carry the Olympic Flame in recognition of her
personal and professional dedication to promoting healthy lifestyles and for empowering civic engagement in communities.
Rosie Curry Connard, RN, retired on April 4th after
working at Baptist Hospital for 44 years. She started her nursing career as an LPN. Rosie is retiring as a Nursing House
Supervisor.
Dorothy Hall, RN, is a retired nurse. She was presented
with the the Community Volunteer Award of the Year for 20102011. Dorothy is a community health advisor and works with
Community Action Team of Shelby County (CATS). CATS is a
community outreach program that supports the fight against
breast and cervical cancer in African American women by providing education and increase screening resources.
34 — NBNA.org
MEMBERS on the MOVE
Northern New Jersey Black Nurses Association (NNJBNA)
Norma L. Rodgers, BSN, RN, CCRA, recently won the election for the New Jersey State
Nurses Association (NJSNA). Norma is President-elect. She was the President of the NJSNA
Region 3. Norma is currently the Senior Site Manager for ReSearch Pharmaceutical Services.
The NNJBNA presented an educational session titled, “How to Effectively Conduct Chapter
Meetings and other Business.” The session presenter was Ronnie Ursin, DNP, RN, NEA-BC,
NBNA Parliamentarian and President of the Black Nurses Association of Baltimore. The chapter
and invited guested had an engaging dialogue on facilitating meetings, rules of debate, constructing amendments, voting, bylaws, and more.
Rosemary Allen-Jenkins, MSN, RN, (right) was elected as the President of NNJBNA.
(above) Dr. Ronnie Ursin, NBNA Parliamentarian, with members of the Northern New Jersey BNA.
(below) Northern New Jersey Black Nurses Association members in attendance at their
educational session on, “How to Effectively Conduct Chapter Meetings and other Business”
presented by Dr. Ronnie Ursin, with Rosemary Allen-Jenkins, newly elected President (sitting
center left) and Sandra Baker, Immediate Past President (sitting center right)
MEMBERS on the MOVE
NBNA.org — 35
Black Nurses Association of Greater Washington DC Area (BNAGWDCA)
The BNAGWDCA held their 32nd Annual Salute to the
Black Nurse of the Year and Scholarship Awards Luncheon at
the Martins’ Crosswinds in Greenbelt, MD. The theme of the
program was, “Perspectives on Nursing: A Past to Remember,
A Future to Shape.” Over 400 guests attended the luncheon
to include many chapter Founders and Lifetime Members,
active duty and retired members of the Army and USPHS, Dr.
Bernadine Lacey, and faculty and students from Delaware.
The keynote presenter for the program was Dr. Barbara L.
Nichols, CEO of Barbara Nichols Consulting, former CEO of
the Commission on Graduates for Foreign Nursing Schools
(CFGNS) and past ANA President. The 2012 Nurse of the Year
was Ottamissiah Moore, BS, LPN, WCC, CLNI. Ottamissiah was the first LPN to receive this annual chapter award.
Tricia K. Baptiste, SN, was the recipient of the 2012 Johnella
Banks Memorial Scholarship. Appreciation to Howard University Hospital Division of Nursing for providing the continuing
nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
Ottamissiah Moore, BS, LPN, WCC, CLNI
Patricia Tompkins, RN, Past president of BNAGWDCA,
represented the chapter on the DC Tobacco Free Coalition,
met with other coalition members and the American Lung
Association to launch Tobacco Control Advocacy Day on
March 23, 2012. Advocacy Day participants met members
of the DC City Council to drive support for tobacco funding
during a week when the City Council was reviewing the 2013
Budget. Patricia Tompkins also discussed, “Age Proof Your
Brain: Ten Easy Ways to Stay Sharpe Forever” at the Gethsemane Baptist Church, Washington, DC, Praise Luncheon
for Seniors on April 2, 2012.
As part of the chapter’s 2012 HIV/AIDS training agenda
and in partnership with Simply Speaking HIV, eight BNA
GWDCA members attended an outstanding CE program
by Richard Elion, MD, entitled, “Understanding HIV/AIDS
Testing and its Impact on Treatment.” The event was held on
March 28, 2012 at the Channel Inn, Washington, DC.
Julia Ugorji, MSN, RN, recently received the master
of science in nursing degree in nursing education from the
Grand Canyon University. Ms Ugorji has been an active
member of the chapter since she joined in 2008. She currently serves on the community service and scholarship
committees. Julia attended the National Health Promotion
Summit in Washington, DC that was held April 10-11, 2012.
Barbara Baskerville, RN, Lillian Wade, RN, Barbara
Patterson, RN and Patricia Tompkins, RN, attended the
2012 Congressional Black Caucus Spring Health Braintrust/
National Minority Quality Forum 9th Annual Leadership
Summit and Awards Dinner held April 23-24, 2012.
Lois Bowman, RN, Doris Hughes, RN and Margaret
Pemberton, RN, continued a long standing effort to share
the goals of the BNAGWDCA Make a Difference: Choose
Nursing Program with the Washington Middle School for
Girls. These members meet with the students at least three
times each school year to talk about the profession of nursing, what nurses do and what it takes to become a nurse.
Beverly Dandridge, MSN, FNP, MSAJS, CCHP,
CAPT USPHS, participated with the 21st Annual USPHS
Nursing Recognition Day program on May 4, 2012 at the
Natcher Conference Center on the NIH campus in Bethesda, MD. The theme for the conference was, “Nursing on the
Forefront: United in Health.” CAPT Dandridge presented a
poster entitled, “Affordable Care Act: What Does It Mean for
Correctional Health?”
Sonia Swayze, RN, Vice-President BNAGWDCA, was
the recipient of the USPHS 2012 Rear Admiral Julia R. Plotnick Publication Award for Health/Nursing policy for her
article, “Promoting Safe Use of Medical Devices.” The article was co-authored and published in OJIN on October 17,
2012. The award was presented on Friday, May 4, 2012, at
the Natcher Conference Center, on the National Institutes of
Health Campus, Bethesda, MD, during the USPHS Annual
Nurse Recognition Day (NRD) program.
During Nurses Week 2012, Velma Henderson, RN,
presented, “Embracing Transition” at Saint Elizabeth’s Hospital in Washington, DC, “Caring for Self” at United Medical
Center, Washington, DC, and “Nurse to Nurse Violence” at
Prince Georges Hospital, Cheverly, MD. All presentations
were in conjunction with the 2012 Nurses Week.
Dr. Eva Stephens, former faculter member at Howard
University, was awarded the Dr. Montague Cobb Award for
her community service work to eradicate health disparities in the black community by the NAACP. The award was
presented at the NAACP 102nd National Convention in Los
Angeles, CA. This award is given to those that have a special
achievement in social justice, health justice, health education /promotion, fundraising and research. Dr. Stephens
implemented a research study on obesity with the BNAGWDCA. Dr. Stephens is a certified Family Nurse Practitioner,
accepted a position as Associate Professor at University of
Texas Medical Branch-Galveston, TX. She has recently accepted a promotion as “Nurse Educator Track Administrator” effective the fall 2012.
36 — NBNA.org
MEMBERS on the MOVE
Fort Bend County Black Nurses
Association (FBCBNA)
Fort Bend County Black Nurses Association Board of Directors
Fort Bend County Black Nurses Association
held a successful 11th President’s Scholarship &
Awards Ball. Dr. Deidre Walton, NBNA President,
and members of the Black Nurses Association of
Greater Houston were in attendance. Dr. Alma A.
Allen, Texas State Representative, was the mistress
of Ceremonies. Dr. Mary Ellen Ross, Scholarship
Chairperson, presented four $1,000 scholarships
to the following nursing students: Tina Battle,
Danielle Davis, Brittany Leffall, and Jacqueline Wilmore. The Lifetime Achievement Award recipient was JoAnn Goodie, RN. Janice Sanders,
RN, was name Nurse of the Year. Dr. Ahia Shabass, was name Volunteer of the Year. Ethelene
Wilmore, RN, was recognized as Board Member
of the Year. Bessie Trammell, RN, received the
award for Recruiter of the Year. The FBCBNA event
was faciliated by Yvonne Olusi, RN, President,
Lola Denise Jefferson, BSN, CVRN, NBNA 2nd
Vice President, and Octavia Sherman, RN, Chair
of the President’s Scholarship and Awards Ball.
(left) Dr. Mary Ellen Ross, Chair, with scholarship
winners Danielle Davis, Tina Battle, Britany
Leffall, Jacqueline Wilmore, and Alma Allen,
Texas State Representative.
Greater Gainesville Black Nurses
Association
Vonchea Bushea, RN,
President, Greater
Gainesville BNA
Atlanta Black Nurses Association
(ABNA)
Patty Palmer, RN, NBNA
Student Representative
Nurses Advocating,
Leading, and Caring
The Greater Gainesville Black Nurses Association held numerous activities during the 2012 Nurses Week to celebrate
the many contributions that nurses make to the profession
everyday. The week long activities were attended by many and
included a Proclamation from the city of Gainesville at the City
Hall, a prostate cancer workshop in conjunction with the Relay
for Life, the annual scholarship and awards luncheon held at
Gainesville Public Library, worship service at Mt. Olive A.M.E.
Church, and a student reception and membership drive at the
Broadmoor Club House, Gainesville, FL.
Dr. Deidre Walton, NBNA President, NBNA Board of Directors, Laurie C. Reid, MS, RN, Atlanta BNA President, and
the officers and members of the Atlanta Black Nurses Association congratulates Patty Palmer on successful completion of
the RN program at South Georgia College. Patty graduated
May 3, 2012. She was also successful on the NCLEX. Patty is
currently working as an RN in the Orthopedics Department at
Tift Regional Medical Center, Tifton, GA.
NBNA.org — 37
MEMBERS on the MOVE
Black Nurses Association, Miami
The First Annual Professional Nursing Organization’s Day
In an effort to find out what nursing organizations a group
of on-line Transitional RN-BSN students at Miami Dade College belonged to, I posed the question, “What professional
nursing organizations do you belong to, why or why not?” I was totally shocked to learn that only about seven out of 65
students belonged to any professional nursing organization.
Of course, students had good legitimate reasons for not belonging or associating with these organizations. Some of the
common reasons centered around 1) finances, 2) time, 3) child
care, 4) confusion about which organization to join and 5) too
many family responsibilities. I then asked a second on-line
group of Transitional RN-BSN students the same questions,
and received very similar responses.
As a recent member of the Florida Nurses Association
(FNA), and the current President of the Miami Chapter of the
National Black Nurses Association (NBNA) here in Miami,
Florida, I wondered if it was possible to develop a collaboration
between the two organizations to see how we could help the
students. The Black Nurses Association (BNA) has also been
struggling with how to increase its’ membership. One of the
organization’s National goals is to increase the membership in
the organization. While a goal of the Miami Chapter BNA is to
build useful collaborations with other nursing organizations.
To help the students learn about the various organizations,
including the Black Nurses Association, I thought it was imperative to do something right away that was drastic and that made
people stand up and take notice. After pondering for weeks over
this, I decided that I needed to collaborate with many nursing
organizations and allow the students to become aware of some
of the benefits afforded to them by their membership. Hence, the
“First Annual Professional Nursing Organizations’ Day” was developed. I invited the presidents and a representative from eight
different professional nursing organizations in the South Florida
area to attend an event. The event was held in conjunction with
Miami Dade College’s School of Nursing program.
Miami Dade College was able to sponsor the entire event.
The groups invited included: Florida Nurses Association (FNA),
Haitian American Nurses Association (HANA), National Hispanic Nurses Association (NAHN), Philippine Nurses Association of South Florida (PNASF), Jamaican Nurses Association of
South Florida (JNASF), Miami Dade College, Student Nurses
Association (MDC-SNA), Indian Nurse Association of South
Florida (INASF), and the Black Nurses Association (BNA). The
groups were asked to come together for one day to inspire and
encourage nursing students to learn what these organizations
were all about. Each President or a representative from the
various groups was asked to talk about what their organization
was doing for nurses in the areas of mentoring and leadership.
Students and faculty from Miami Dade College, Barry University, Florida International University, University of Miami, Broward College and all Registered Nurses and Advanced Registered Nurse Practitioners from the South Florida area were
invited. The event allowed participants to talk with each of the
groups and gather information. The guest speaker for the event
was Ms. Willa Fuller, Executive Director of Florida Nurses Association, Dr. Georgia Labadie, Professor Emeritus, from the
University of Miami, and Ms. Annette Gibson, Professor from
Miami Dade College’s School of Nursing.
The event was extremely successful. Over 200 participants
(standing room only) came out to learn about the organizations.
The organizations were prepared with pamphlets, newsletters,
and of course applications for membership. This turned out
to be a win-win situation for all involved. I was overwhelmed
with the responses from students, nurses and faculty. I am sure
that each organization was able to gain some new members
from this wondrous event. In fact, before the event was over,
students and nurses asked if we could have the same event
every year, but in a bigger auditorium.
Columbus Georgia Metro Black Nurses (CBNA)
CBNA participated in the Annual Health Fair sponsored
by St. Mary Road United Methodist Church on April 21, 2012.
CBNA provided Emotional Vital sign screening and the results
were reviewed with participants.
CBNA hosted the Annual X-cellence Award Banquet at
Regimental Hall in Fort Benning, GA on May 19, 2012. This
annual event is in recognition of Nurses Week and provides
scholarships to aspiring nursing students.
Florence Miller, MSN, RN, completed the third level of
the Healing Touch program from April 21st to 22nd. Florence
has used the concepts/skills in the program to provide healing
touch sessions at her church and at local health events.
Stephanie Gordon, BSN, RN, successfully completed
her nursing training at Columbus State University in Columbus,
GA. Stephanie has been accepted into the Master in Nursing
Program at Columbus State University in Columbus, GA. She
accepted a position as an RN at St. Francis Hosital. Stephanie
is also a member of Sigma Gamma Rho Sorority, Collegiate
Women of Wisdom and is the Student Nurse Recruiter for
CBNA.
Eileen Albritton, MSN, RN, retired from the Columbus
Health Department after 34 years of service as the District
Nurse and Clinical Director for the Columbus Georgia Health
Department. Eileen currently provides training on Effective Interviewing Skill and is working to develop an outreach ministry
program at her church.
Georgia Stampley, RN, has been recognized by the
Central District Lay Organization for over 20 years of service.
Georgia was selected and received the Outstanding Senior
Distinction Award honor on May 26, 2012 by the J.U.G.S. International Organization at the Green Island Country Club.
Agnes Shelton, RN, and Gwendolyn McIntosh, RN, are
members of the Domestic Violence Round table. Gwendolyn is
the representative for CBNA.
38 — NBNA.org
MEMBERS on the MOVE
Bay Area Black Nurses Association
ABOVE: The Steptoe Group, Dr. Debow, Dr. Shirley
Evers-Manly, Congresswoman Donna Christensen,
Congresswoman Barbara Lee, & Kim Scott, Bay Area
BNA President and members.
Kimberly Scott, MSN, MBA, RN, Bay Area BNA President
at the Flo Stroud Conference with high school students
from Bishop O’Dowd High School in Oakland, CA.
The Bay Area Black Nurses Association (BABNA) held their
2nd Annual Florence Stroud Black History Conference Series
in February, 2012. The title was, “Joining Forces: Answering
the Call to Support Military Families.” The chapter partnered
with the University of San Francisco’s (UCSF) Department of
Nursing. Congresswomen Barbara Lee, CA (D) and Donna
Christensen Virgin Islands (D) were the Keynotes. Dr. Shirley
Evers-Manly was the producer of the conference. She is the
Associate Dean of Academic Affairs of the nursing school at
UCSF and a member of BABNA. The discussion focused on
how the BABNA, with community partners, could support military families. A panel discussion of Veterans, counselors, and
family members of veterans was held to understand the challenges that are faced and how the community (i.e., BABNA)
can support men and women as they adjust back into civilian
life. The chapter was enlightened on the how to get funds to
help support military families in the community. The discussion helped to develop a task force of interested individuals to
answer the call.
The chapter also had the opportunity to share with the two
Congresswomen the need for jobs and new graduate training
programs in the acute care settings in California and across
the US. They were eager listeners. They voiced how they
were not aware of the issue, and actually shocked that there
aren’t many jobs for the new graduate nurse. They reported
that they would take this information back to the White House/
Congress. Since the conference, Barbara Lee has asked the
BABNA for more information on this topic when she went to
the Appropriations Committee Hearing with Secretary Sebilius.
The IOM report was discussed with the congresswomen. The
chapter was encouraged to write legislative representatives informing them how the community is affected. There were over
200 in attendance. The Air Force, Navy, and Army had exhibit
tables. South Bay Area of San Jose BNA members, Dr. Irene
Daniel-Lewis, NBNA Treasurer and Sandra McKinney, RN,
and Sharon T. Smith, RN, San Diego BNA President, were in
attendance.
Greater Gainesville Black Nurses
Association (GGBNA)
Greater Gainesville BNA was mentioned in a local newspaper
for assisting in the community FluMist program that was recently
recognized as the most effective flu prevention program in the nation.
MEMBERS on the MOVE
NBNA.org — 39
NBNA Member Highlights in Photos
Members of the Black Nurses Association of Greater Washington DC Area participate in the 32nd Annual Salute to the
Black Nurse of the Year and Scholarship Awards Luncheon
Military personnel in attendance at the Black Nurses Association of Greater Washington DC Area 32nd Annual Salute to the
Black Nurse of the Year and Scholarship Awards Luncheon
40 — NBNA.org
NBNA Chapter Websites
Alabama
Birmingham BNA.......................................www.birminghambna.org
Arizona
Greater Phoenix BNA................................www.bnaphoenix.org
California
Council of BN, Los Angeles......................www.cbnlosangeles.org
Inland Empire BNA....................................www.iebna.org
San Diego BNA..........................................www.sdblacknurses.org
S. Bay Area of San Jose BNA...................www.sbbna.org
Colorado
Eastern CO Council of BN (Denver)..........www.coloradoblacknurses.org
Connecticut
Northern Connecticut BNA.......................www.ncbna.org
Southern Connecticut BNA.......................www.scbna.org
District of Columbia BNA of the Greater DC Area.....................www.bnaofgwdca.org
Florida
BNA, Miami................................................www.bna-miami.org
Central Florida BNA...................................www.cfbna.org
First Coast BNA.........................................www.fcbna.org
St. Petersburg BNA...................................www.orgsites.com/fl/spnbna
Georgia
Atlanta BNA...............................................www.atlantablacknursesassociation.com
Concerned BN of the
Central Savannah River Area.................www.cncsra.org
Savannah BNA...........................................www.sb-na.org
Hawaii
Honolulu BNA............................................www.honolulublacknures.com
Illinois
Chicago Chapter BNA...............................www.chicagochapternbna.org
Indiana
BNA of Indianapolis...................................www.bna-indy.org
Kentucky
KYANNA BNA (Louisville)..........................www.kyannabna.org
Louisiana
New Orleans BNA......................................www.neworleansbna.com
Shreveport BNA.........................................www.sbna411.org
Maryland
BNA of Baltimore.......................................www.bnaofbaltimore.org
Massachusetts
New England Regional BNA......................www.nerbna.org
Michigan
Greater Flint BNA.......................................www.gfbna.org
Mississippi
Mississippi Gulf Coast BNA......................www.mgcbna.org
Missouri
Greater Kansas City BNA..........................www.gkcblacknurses.org
Nevada
Southern Nevada BNA..............................www.snbna.net
New Jersey
Concerned BN of Newark.........................www.cbnn.org
Northern New Jersey BNA........................www.nnjbna.com
New York
New York BNA...........................................www.nybna.org
Queens County BNA.................................www.qcbna.com
North Carolina
Central Carolina BN Council.....................www.ccbnc.org
Ohio
Columbus (Ohio) BNA...............................www.columbusblacknurses.org
Youngstown-Warren BNA.........................www.ywobna.org
Oklahoma
Eastern Oklahoma BNA............................www.eobna.org
NBNA.org — 41
PENNSYLVANIA
South Eastern PA Area BNA.....................www.sepabna.org
Tennessee
Nashville BNA............................................www.nbnanashville.org
Texas
BNA of Greater Houston...........................www.bnagh.org
Metroplex BNA (Dallas).............................www.mbnaofdallas.org
Wisconsin
Milwaukee Chapter NBNA.........................www.mcnbna.org
screening (continued from page 8)
Conclusion
The American Cancer Society (2012) reports African American women are more likely to die from breast cancer than any
other ethnic group. Consequently, it is imperative that African
American women become more informed about breast cancer.
African American women must be educated about the risk factors, the deterrents to breast cancer screening, and the strategies necessary to prevent, detect, and treat breast cancer. It is
critical that more research and education be conducted to provide the support and resources needed to reduce the mortality
and prevalence of breast cancer in African American women.
References
American Cancer Society. (2012). Cancer facts and figures.
Atlanta, GA: Author.
Baskin, M. L., Gary, L. C., Hardy, C. M., Yu-Mei, S., Scarinci,
I., Fouad, M. N., & Partridge, E. E. (2011). Predictors of retention
of African American women in a walking program. American
Journal of Health Behavior, 35(1), 40-50.
Kelley, M. (2011). Recruitment of African American women
for research on breast cancer early detection: using culturally
appropriate interventions. Southern Online Journal of Nursing
Research, 11(1).
McCaskill, J. (2006). African American women, self-breast
examination and Health Belief Model: implications for practice.
JOCEPS: The Journal of Chi Eta Phi Sorority, 52(1), 33-37.
Phillips, J., & Cohen, M. Z. (2011). The meaning of breast cancer
risk for African American women. Journal of Nursing Scholarship, 43(3), 239-247. doi:10.1111/j.1547-5069.2011.01399.x
Ravert, P., & Huffaker, C. (2010). Breast cancer screening in women: An integrative literature review. Journal of The
American Academy of Nurse Practitioners, 22(12), 668-673.
doi:10.1111/j.1745-7599.2010.00564.x
United States Census. (2010). Population by sex and
age. Retrieved on May 11, 2012 from http://2010.census.
gov/2010census/
Charlotte M. Wood is a PhD candidate. She is an assistant professor in the College of Health Professions, Helene Fuld
School of Nursing at Coppin State University.
Dr. Joan S. Tilghman is Professor and Associate Dean,
Helen Fuld School of Nursing at Coppin State University. She
earned her Ph.D. in Transcultural Nursing at the University of
Miami in Coral Gables, Florida. Dr. Tilghman is a nationally certified Women’s Health Nurse Practitioner.
call to action (continued from page 15)
n
Developing strategies aimed at increasing breastfeeding
initiation and duration among African American women
that are culturally sensitive and appropriate, recognizing
that there are historical contexts that may act as deterrents
for breastfeeding.
n Supporting workplace initiatives for breastfeeding, specifically where many African American mothers work such
as service settings, factories or other work place settings
which have traditionally posed major obstacles for women
desiring to maintain exclusive breastfeeding for 6 months.
n Ensuring that our NBNA members who work in settings
that provide care for mothers and possess the basic skills
and competencies advocated by the USBC: Breastfeeding
Competencies for Health Care Professionals
n Encouraging NBNA members should consider achieving
certification as lactations specialist, increasing the diversity
among lactation specialist , thus making services more
available to women of color as well as lend itself to the development of more culturally relevant strategies to increase
the initiation and duration of breastfeeding.
References
American Academy of Pediatrics (2005). Policy statement: Breastfeeding and human milk. Pediatrics, 115(2), 496-506.
Health and Human Services (2011). Executive Summary: The Surgeon
General’s Call to Action to Support Breastfeeding. Washington,
D.C., Office of the Surgeon General.
Chung, S., Raman, G., Chew, P., Magula, N., DeVine, D., Trikalinos,
T., & Lau, J. (2007). Breastfeeding and maternal and infant health
outcomes in developed countries. Evidence Report/Technology
Assessment. (133). Prepared by Tufts New England Medical Center
Evidenced based practice center, AHQR Publication No. 07-E007,
Rockville, MD.
Patton, L.M., Alexander, J.L., & Nowson, C.A.,(2003). Pregnancy and
lactation have no long term deleterious effect on measures of bone
mineral in healthy women: a twin study. American Journal of Clinical
Nutrition, (77), 707-714.
Sharps, P. (2009). Breastfeeding: A strategy for preventing maternal
and child health disparities. Medications and More. 3(10), 3-4.
Voices for American Children (2010). A Call to Action On Breastfeeing.
Retrieved on May 11, 2012 from http://www.voices.org.
Dr. Phyllis W. Sharps is Professor and the Associate Dean,
Community and Global Programs at Johns Hopkins University
School of Nursing in Baltimore, MD. Dr. Sharps is the NBNA
Representative to United States Breastfeeding Committee.
NBNA CHAPTER PRESIDENTS
ALABAMA
BIRMINGHAM BNA (11)
Deborah Andrews
Birmingham, AL
MOBILE BNA (132)
Dr. Yolanda Turner
Mobile, AL
MONTGOMERY BNA (125)
Tonya Blair
Birmingham, AL
ARIZONA
GREATER PHOENIX BNA (77)
Dr. Monica Ennis
Phoenix, AZ
ARKANSAS
LITTLE ROCK BNA OF ARKANSAS
(126)
Cheryl Martin
Little Rock, AR
CALIFORNIA
BAY AREA BNA (02)
Kimberly Scott
Hayward, CA
COUNCIL OF BLACK
NURSES, LOS ANGELES (01)
Joyce Spalding
Los Angeles, CA
INLAND EMPIRE BNA (58)
Sandra Waters
Riverside, CA
SAN DIEGO BNA (03)
Sharon Smith
San Diego, CA
SOUTH BAY AREA BNA (San Jose)
(72)
Sandra McKinney
San Jose, CA
COLORADO
EASTERN COLORADO COUNCIL OF
BLACK NURSES (DENVER) (127)
Chris Bryant
Denver, CO
CONNECTICUT
NORTHERN CONNECTICUT BNA (84)
Lisa Davis
Hartford, CT
SOUTHERN CONNECTICUT BNA (36)
Katherine Tucker
New Haven, CT
DISTRICT OF COLUMBIA
BNA OF GREATER
WASHINGTON, DC AREA (04)
Diana Wharton
Washington, DC
FLORIDA
BIG BEND BNA (Tallahassee) (86)
Hester O’Rourke
Blountstown, FL
BNA, MIAMI (07)
Lenora Yates
Miami Gardens, FL
BNA OF TAMPA BAY (106)
Rosa Cambridge
Tampa, FL
BNA OF THE TREASURE COAST
(122)
Felicia Stewart
Vero Beach, FL
BROWARD COUNTY FLORIDA BNA
(120)
Cornell Hampton
Hollywood, FL
CENTRAL FLORIDA BNA (35)
Constance Brown
Orlando, FL
CLEARWATER/LARGO BNA (39)
Audrey Lyttle
Largo, FL
FIRSTCOAST BNA (103)
(JACKSONVILLE)
Pearl Rigby
Jacksonville, FL
GREATER GAINESVILLE BNA (85)
Voncea Brusha
Gainesville, FL
PALM BEACH COUNTY BNA (114)
Louise Aurelien
RoyalPalm Beach, FL
ST. PETERSBURG BNA (28)
Janie Johnson
St. Petersburg, FL
GEORGIA
ATLANTA BNA (08)
Laurie Reid
College Park, GA
COLUMBUS METRO BNA (51)
Gwendolyn McIntosh
Columbus, GA
CONCERNED NATIONAL BLACK
NURSES OF CENTRAL SAVANNAH
RIVER AREA (123)
Beulah Nash-Teachey
Martinez, GA
SAVANNAH BNA (64)
Lou Roberson-Harris
Savannah, GA
HAWAII
HONOLULU BNA (80)
Angelo Moore
Aiea, HI
ILLINOIS
CHICAGO CHAPTER BNA (09)
Carolyn Rimmer
Chicago, IL
INDIANA
BNA OF INDIANAPOLIS (46)
Sandra Walker
Indianapolis, IN
NORTHWEST
INDIANA BNA (110)
Mona Steele
Merrillville, IN
KANSAS
WICHITA BNA (104)
Peggy Burns
Wichita, KS
KENTUCKY
NEVADA
PENNSYLVANIA
KYANNA BNA, LOUISVILLE (33)
Virginia Bradford
Louisville, KY
SOUTHERN NEVADA BNA (81)
Ann Hall
Las Vegas, NV
LOUISIANA
NEW JERSEY
ACADIANA BNA (131)
Jeanine Thomas
Lafayette, LA
NEW ORLEANS BNA (52)
Trilby Barnes-Green
New Orleans, LA
SHREVEPORT BNA (22)
Dr. Katheryn Arterberry
Shreveport, LA
NEW ENGLAND REGIONAL BNA (45)
Margaret Brown
Roxbury, MA
WESTERN MASSACHUSETTS BNA
(40)
Gloria Wilson
Springfield, MA
CONCERNED BLACK
NURSES OF CENTRAL
NEW JERSEY (61)
Sandra Pritchard
Neptune, NJ
CONCERNED BLACK
NURSES OF NEWARK (24)
Lynda Arnold
Newark, NJ
MID-STATE BNA OF NEW
JERSEY (90)
Rhonda Garrett
Somerset, NJ
NEW BRUNSWICK BNA (128)
Barbara Burton
New Brunswick, NJ
NORTHERN NEW JERSEY BNA (57)
Sandra Baker
Newark, NJ
SOUTH JERSEY CHAPTER OF THE
NBNA (62)
Gail Edison
Williamstown, NJ
PITTSBURGH BLACK
NURSES IN ACTION (31)
Diana Byas
Pittsburgh, PA
SOUTHEASTERN
PENNSYLVANIA BNA (56)
Juanita Jones
Philadelphia, PA
MICHIGAN
NEW YORK
DETROIT BNA (13)
Nettie Riddick
Detroit MI
GRAND RAPIDS BNA (93)
Earnestine Tolbert
Grand Rapids, MI
GREATER FLINT BNA (70)
Darnita Evans
Flint, MI
KALAMAZOO-MUSKEGON BNA (96)
Birthale Archie
Kentwood, MI
SAGINAW BNA (95)
Archia Jackson
Saginaw, MI
NEW YORK BNA (14)
Susan Thompson
New York, NY
QUEENS COUNTY BNA (44)
Chidimma Azoro
Cambria Heights, NY
WESTCHESTER BNA (71)
Altrude Lewis-Thorpe
Yonkers, NY
MARYLAND
BNA OF BALTIMORE (05)
Patricia Medley
Baltimore, MD
MASSACHUSETTS
MINNESOTA
NORTH CAROLINA
CENTRAL CAROLINA COUNCIL (53)
Helen Horton
Durham, NC
OHIO
GREATER KANSAS CITY BNA (74)
Jean Winfield
Kansas City, MO
AKRON BNA (16)
Cynthia Bell
Akron, OH
BNA OF GREATER CINCINNATI (18)
Jennifer Pearce
Cincinnati, OH
CLEVELAND COUNCIL BNA (17)
Peter Jones
Cleveland, OH
COLUMBUS BNA (82)
Stephanie McCoy
Columbus, OH
YOUNGSTOWN WARREN BNA (67)
Lynn Hines
Youngstown, OH
NEBRASKA
OKLAHOMA
OMAHA BNA (73)
Aubray Orduna
Omaha, NE
EASTERN OKLAHOMA BNA (129)
Wendy Williams
Tulsa, OK
MINNESOTA BNA (111)
Shirlynn LaChapelle
Minneapolis, MN
MISSISSIPPI
MISSISSIPPI GULF COAST BNA
(124)
Charlotte Gore
Gulfport, MS
MISSOURI
SOUTH CAROLINA
TRI COUNTY BNA OF
CHARLESTON (27)
Debbie Bryant
Charleston, SC
TENNESSEE
MEMPHIS-RIVERBLUFF BNA (49)
Linda Green
Memphis, TN
NASHVILLE BNA (113)
Shawanda Clay
Nashville, TN
TEXAS
BNA OF GREATER HOUSTON (19)
Ruth Caggins
Houston, TX
FORT BEND COUNTY BNA (107)
Yvonne Olusi
Missouri City, TX
GREATER EAST TEXAS BNA (34)
Pauline Barnes
Tyler, TX
GALVESTON COUNTY GULF COAST
BNA (91)
Patricia Toliver
Galveston, TX
METROPLEX BNA (DALLAS) (102)
Tonya Hill
Dallas, TX
SOUTHEAST TEXAS BNA (109)
B. Midge Jacobs
Port Arthur, TX
VIRGINIA
BNA OF CHARLOTTESVILLE (29)
Randy Jones
Charlottesville, VA
CENTRAL VIRGINIA BNA (130)
Janet Porter
Richmond, VA
NBNA: NORTHERN VIRGINIA
CHAPTER (115)
Joan Pierre
Woodbridge, VA
WISCONSIN
MILWAUKEE BNA (21)
JoAnn Lomax
Milwaukee, WI
RACINE-KENOSHA BNA (50)
Gwen Perry-Brye
Racine, WI
DIRECT MEMBER (55)
*IF THERE IS NO CHAPTER IN YOUR
AREA

Health Care in the African American Community

Transcription

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