Addressing health challenges for African American families: Type II diabetes, mental health, illness prevention, obesity and dental health for children.

THE NBNA NEWS IS THE OFFICIAL PUBLICATION OF THE NATIONAL BLACK NURSES ASSOCIATION FALL

2013

NBNA NEWS The NBNA News is printed quarterly; please contact the National Office for publication dates. NBNA News • 8630 Fenton Street, Suite 330 • Silver Spring, MD 20910 • www.NBNA.org

Ronnie Ursin, DNP, MBA, RN, NEA-BC, Editor-in-Chief NBNA National Office Staff Millicent Gorham, DN(Hon), MBA, FAAN(Hon) Executive Director and Associate Editor Estella A. Lazenby, CMP Membership Services Manager Frederick George Thomas Administrative Assistant Gessie Belizaire, MA Administrative Assistant Dianne Mance Conference Services Manager BOARD OF DIRECTORS: Deidre Walton, JD, MSN, RN President, Scottsdale, AZ Eric J. Williams, DNP, RN, CNE 1st Vice President, Los Angeles, CA Lola Denise Jefferson, BSN, RN, CVRN 2nd Vice President, Houston, TX Beulah Nash-Teachey, PhD, RN Treasurer, Evans, GA Martha Dawson, DNP, RN, FACHE Secretary, Birmingham, AL Debra A. Toney, PhD, RN, FAAN Immediate Past President, Las Vegas, NV

Ronnie Ursin, DNP, MBA, RN, NEA-BC Parliamentarian, Frederick, MD Irene Daniels-Lewis, DNSc, RN, APN, FAAN Historian, Redwood City, CA Darnell Caldwell, SN Student Representative, New Orleans, LA Trilby A. Barnes-Green, RNC New Orleans, LA Keneshia Bryant, PhD, RN, FNP-BC Little Rock, AR Monica Ennis, EdD, MSHA, RN Phoenix, AZ Audwin Fletcher, PhD, APRN, FNP-BC, FAAN Jackson, MS C. Alicia Georges, EdD, RN, FAAN Ex-Officio, Bronx, NY Melba Lee Hosey, BS, LVN Houston, TX Deborah Jones, MS, RN-C Texas City, TX Sandra McKinney, MS, RN San Jose, CA Laurie C. Reid, MS, RN Atlanta, GA Col. Sandra Webb-Booker, PhD, RN Chicago, IL

NBNA Newsletter NBNA Newsletter Criteria for Submitting Articles: • 500-750 Word Article • Title of Article, Author’s Name and Credentials (Alison Brown, MSN, RN) • Three-line biographical sketch & author’s headshot photograph (professional-quality, high res) • Resources where appropriate • Send all articles, member news, chapter highlights, pictures, and other information to [email protected]

© 2013 NBNA

President’s Message

T Dr. Deidre Walton, President National Black Nurses Association

his fall brought the United States into its final phase of the 2010 Patient Care and Affordable Care Act (ACA). October launched the Health Insurance Marketplace as a key component of ACA. For millions of Americans, this means affordable options and access to primary health care. As the 2014 expansion of coverage mandated by ACA becomes more imminent, one question remains: How will health care providers, policymakers, and payers cope with an expected surge in patient demand for services.

Is nursing ready for this emerging marketplace? Discussions have occurred regarding how nursing roles will change since the passage of ACA. Nursing professions represents a critical portion of health practitioners in meeting the demands of the new health care system. The Institute of Medicine (IOM) stated that transforming the health care system to provide safe, quality, patient-centered, accessible, and affordable care will require a comprehensive rethinking of the roles of many health care professionals; nurses chief among them. One of the critical roles that we, as nurses, play in the final phases of implementation of ACA is consumer empowerment through education; a key area being enrollment assistance. Nurses will play a critical role in helping consumers understand the process and their options. Access to healthcare is an important pre-requisite to obtaining quality care. ACA is an important milestone in addressing the issue of the uninsured, pre-existing health conditions, and health insurance for the nation’s children. As NBNA continues to advocate for solutions for the underserved and unserved, we must continue to educate consumers to be in charge of their health care. We have an important role to advocate and ensure that there is not only access to care but recognize that high quality care is a universal issue. It is equally imperative that while health cost rise there is an increased focus on prevention and wellness. Chapters of NBNA are actively engaged with educating their communities. Members of the Black Nurses Association of the Greater Phoenix Area partnered with local barbershops to help consumers understand their coverage options through the new health insurance marketplace, Medicaid and the children’s health insurance program, and determine their eligibility. Consumers were also educated on financial assistance available and assisted with enrollment in new affordable health coverage options. NBNA continues its legacy in making an impact in communities across the nation. NBNA has been guided by the principle that African American nurses have the understanding, knowledge, interest, and expertise to make a significant difference in the health care status of African American communities across the nation throughout history. NBNA, we must remain consistent with our mission. Together, we are soaring like eagles.

2 — NBNA.org A Letter from the Editor

Ronnie Ursin, DNP, MBA, RN, NEA-BC Editor-in-Chief

Greetings!

A

warm good-bye to 2013 as we await a celebratory welcome to 2014. I hope that this year has been phenomenal for each of you and that you plan to have an enjoyable and prosperous New Year. The National Black Nurses Association (NBNA) continues to be a respected professional organization throughout the profession of nursing. As we take a look back over 2013, we can celebrate and appreciate all of the great work that has been done in our communities at the national and local levels. We are developing, implementing, and maintaining programs that are impactful and necessary for health improvement for us, family, and community. Chapters are breaking new ground and continuing to remain steadfast on the mission of NBNA. Here are some highlights that reflect our focus on the mission in 2013: n NBNA produced a stellar NBNA Day on Capitol Hill and had to opportunity to honor Honorable Louis Stokes, Dr. C. Alicia Georges, Mr. William “Larry” Lucas and Honorable Donna Christensen for serving as trailblazers that led the way for NBNA Day on Capitol Hill to be established and upheld. n Researcher, Dr. Ida J. Spruill, continued efforts and inclusion of NBNA in international research on genetics. n We celebrated the life and legacy of Dr. Gloria Smith, NBNA Co-Founder. n Chapters like the Greater East Texas BNA continued their work on hypertension and diabetes education/screening and a focus on men’s health. Birmingham BNA, Community Service Award recipient, is driving change through health education and screenings in the Birmingham region. n We remain focused on the Future of Nursing by honoring our past President, Dr. Linda Burnes Bolton and colleague, Dr. Donna Shalala, on their contribution to the report and implementation of the recommendations on the Future of Nursing. n We are mentoring and developing students across the country and welcoming new contributors that are financially assisting us to provide support to these students such as United Health. n Our members are head-liners in healthcare and making positive impacts on care delivery and education. Several members include Dr. Romeatrius Moss (Mississippi BNA), Ottamissiah ‘Missy’ Moore (Southern Maryland BNA), and Dr. Marie O. Etienne (BNA, Miami Chapter).

n

NBNA convened another successful institute and conference in New Orleans, LA. Highlighted during the conference were excellent presentations during the plenary sessions, institutes, and workshops addressing nursing education, practice, research and leadership. The Chapter Presidents and Vice-Presidents received valuable information on dental health, domestic violence, succession planning and an outstanding presentation on parliamentary procedures from one of the authors of Robert’s Rules of Order edition. The conference attendees were energized by the thought provoking keynote address during the Opening Ceremony from Dr. Karen Ragland-Cole, Vice-President of Pediatric Radiology at the Long Beach Memorial Hospital in Long Beach, California and by the Closing Session Speaker, Patricia Ross, MSN, RN, CLNC, (Colonel Retired US Army), Legal Nurse Consultant, and Sole Proprietor, Frontline Medical Legal Consulting Services as she addressed, “Crushing the Tide of Deadly Health Care Mistakes—A Nursing Imperative.” n We are proud of the nurses in the New England region setting the stage for excellence in nursing practice, education, and training including Cheryl Tull, Dr. Marion Winfrey, Michelle Renaud, Ketline Edouard, Christine Brown, Sheran Woodroffe, Cheryl Xavier, Sheryl Fernandes, Dr. Clara Gona, and Makeda Kamara. n NBNA welcomed several new chapters to the family: Middlesex Regional BNA (New Jersey); Bayou Regional BNA (Louisiana); SandHills North Carolina BNA, BNA of Southern Maryland; Central Mississippi BNA; and Minority BNA of Florence, SC. As you can see, the work continues. Our drive is unstoppable. We are commitment to the legacy of our founders and our mission. This edition of NBNA News culminates another successful year of bringing you quality readings on health issues that we address in our professional duties on a daily basis and information on chapter events. The focus of this edition is on health promotion and illness prevention. The articles highlight information on diabetes, mental health, dental health, sexting, obsesity, HIV/AIDS, and genetic. We applaud all of our writers/authors for their continued contribution to this publication. Happy New Year to each of you!

NBNA.org — 3 TABLE OF CONTENTS Campaign Against Diabetes Mellitus Type II..............................................................4 Strategies to Enhance Diabetes Prevention..............................................................5 Methadone Versus Suboxone Treatment...................................................................8 Strategies to Improve Mental Health Outcomes...................................................... 11 Distress in Patients with Cancer............................................................................... 12 Pediatric Dental Health............................................................................................. 13 Genetic Research and Opt-Out Consent................................................................. 17 Emerging Focus on Mental Health........................................................................... 18 The Sexting Phenomenon........................................................................................ 19 Halting the Tide of Childhood Obesity.....................................................................21 A New Cardiovascular Innovation ............................................................................22 African Americans’ Poor Type 2 diabetes Outcomes..............................................23 Emotional Maturity and Health Promotion...............................................................24 Gender Differences in PSD......................................................................................25 The Role of the Church on HIV/AIDS.......................................................................27 BBNA - Mentorship in Action!..................................................................................29 Mentoring: A Professional Investment.....................................................................30 Reflections on the NBNA Conference......................................................................31 Preparing for War’s Aftermath..................................................................................32 Chapter News & Members on the Move..................................................................33 NBNA Election Criteria.............................................................................................42 Chapter Websites.....................................................................................................44 Chapter Presidents...................................................................................................46 NBNA Membership Application...............................................................................48

4 — NBNA.org NBNA’s Campaign Against Diabetes Mellitus Type II Ida J. Spruill, PhD, RN, LISW, FAAN

Associate Professor Medical University of South Carolina

Irene Daniels Lewis, PhD, RN, FAAN

Professor Emeritus San Jose State University of California

D

r. Deidre Walton, NBNA President, had a vision to launch a NBNA National Program Initiative to “Fight Against Diabetes Mellitus Type II” with a focus on prevention and wellness. In 2012, at the NBNA Conference Diabetes Institute, a resolution was drafted to fight against Diabetes. It was adopted by the Board of Directors and the membership at the national convention in New Orleans, LA. In the forefront of this National Campaign are Drs. Ida Spruill and Irene Daniels Lewis. After the Institute Drs. Spruill and Daniels Lewis met with the American Diabetes Association African American Initiative (ADA/AAI) Representatives and together the two organizations are collaborating to increase the awareness of Diabetes Mellitus Type II in African American (AA) communities across these United States. This national campaign between NBNA and ADA/AAI has 2 phases. The first phase has a set of activities planned for the month of November 2013. The second phase has a set of activities planned for March 2014. Emphasis will also be upon increasing adherence to treatment plans to increase the quality of life for those AA afflicted with this chronic disease. NBNA members have always provided health education and advocacy to AA communities related to Diabetes Mellitus; however, this is the first time NBNA members in the local chapters across thirty-three states will be part of a national program using the same designed interventions. An on-line survey has been conducted to give us information about services members have provided in the past, as well as some suggestions for the national campaign, NBNA’s Fight Against Diabetes Mellitus Type II. Currently, nearly 26 million Americans have diabetes and 79 million have pre-diabetes a condition defined as blood glucose levels higher than normal but not yet high enough to be diagnosed with diabetes (100-125 mg/d) (American Diabetes Association). The Center for Disease Control (CDC) projects that if the current trends continue, as many as 1 in 3 U.S. adults could develop diabetes by 2050. Not surprisingly, Type 2 Diabetes Mellitus (T2DM) represents 95% of all diabetes cases and disproportionately affects the elderly and other ethnic minority groups. (American Diabetes Association) Diabetes Mellitus (DM) remains a lifelong, chronic disease with challenging health and economic outcomes. Projected direct and indirect costs in the United States alone are well over 1.6 trillion dollars by 2031 (Fitch, 2010). Responsible for more deaths than breast cancer and AIDS combined, DM is the seventh leading cause of death, affecting 8.3% of all Americans, and 11.3% of adults aged 20 and older, (Center for Disease Control, 2011; Diabetes Report Card, 2012). The burden of diabetes (14.7%) among African American (AA) is extremely worrisome because as a group, AA are 1.8 times more likely to develop diabetes when compared to

Ida J. Spruill

Irene Daniels Lewis

Non-Hispanic Whites, less likely to be insured, and less likely to have access to affordable, acceptable health care (Chow, Foster, Gonzalez, & McIver, 2012). Furthermore, research indicates that AAs are more likely to develop serious preventable complications leading to blindness, renal failure, and amputations. As a deliberating condition affecting all ethnic minorities, it is imperative that health advocacy organizations such as NBNA become active, visionary leaders in educating the communities about the seriousness of diabetes. Some collaborating activities with the national campaign in the “Fight Against Diabetes Mellitus Type II” that chapters maybe interested in are: Live Empowered takes a targeted approach by ADA/AAI subcommittee to increasing the awareness of the seriousness of diabetes. Choose to Live: This diabetes awareness toolkit targets African-American women between the ages of 35-55. POWER: Provide your church with resources (six modules) for creating awareness about diabetes. Series: Just A Touch is a community based educational module that discusses nerve damage, also known as neuropathy. Reference American Diabetes Association. (ADA) www.diabetes.org. Center for Disease Control and Prevention (CDC) Diabetes data and trends. Retrieved 1/8/2013, from http://apps.nccd.cdc.gov/ DDTSTRS/default.aspx CDC System: Number of people with diabetes increases to 24 million. Retrieved October 30, 2012, from http://www.cdc.gov/media/ pressrel/2008/r080624.htm Chow E, Foster H, Gonzalez V, McIver L. (2012). The disparate impact of diabetes on racial/ethinic minority populations. Clin. Diabetes, 30(3), 130-133. Diabetes Report Card 2012. Atlanta, GA: Centers for Disease Control and Prevention. Fitch, K., Iwasak, K., Pyenson, B. (2010). Improved management can help reduce economic burden of diabetes. New York, NY: Milliman, Inc.

NBNA.org — 5 Health Promotion Strategies to Enhance Diabetes Prevention

D

iabetes mellitus is a group of chronic metabolic diseases characterized by high levels of blood glucose (blood sugar). In a person with diabetes, the normal use of food for energy is disrupted because of defects in insulin production, insulin action, or both. Insulin is a hormone which assists with the uptake of glucose into the body’s cells. When insulin is defective, the normal pathway of energy production is disrupted and high blood glucose levels result. When glucose is not metabolized properly it remains in the blood stream leading to hyperglycemia and thus can affect many vital organs (1-4). Diabetes has reached epidemic portions, affecting approximately 25.8 million adults and children in the US or 8.3% of the population. Of those, 17.9 million have been diagnosed and 5.7 million are undiagnosed. Ninety percent of individuals with diabetes have type 2 diabetes. Diabetes is the 7th leading cause of death and people with diabetes suffer more disproportionately from the complications of diabetes, such as heart disease, amputations, end stage renal disease and blindness. In 2010, the incidence of diabetes was 1.9 million new cases in people over 20 years of ages. It is estimated by the year 2050 that 1 in 3 US adults will have diabetes (1-4). It is estimated that individuals may have elevated blood glucose level 7-10 years before they are diagnosed with overt diabetes. This “prediabetes” state is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Other names for prediabetes are impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on the test used to measure blood glucose levels. Having prediabetes puts one at higher risk for developing type 2 diabetes. People with prediabetes are also at increased risk for developing cardiovascular disease. There are approximately 79 million adults who have pre-diabetes or are at increased risk of developing type 2 diabetes in the future (1). Risks Factors for PreDiabetes The risk factors for prediabetes and diabetes are the same. Some health care providers have added the addition of the Metabolic Syndrome, which is a constellation of risk factors that predispose an individual for cardiovascular disease and type 2 diabetes. Understanding these risk factors and how to lower risk become important for health promotion and prevention activities (Table 1 and 2). Can diabetes can be Prevented? The Diabetes Prevention Program (DPP), sponsored by the National Institutes of Health was a large multicenter clinical research study aimed at discovering whether lifestyle modification (modest weight loss through dietary changes and increased physical activity) or treatment with the oral diabetes medications metformin (Glucophage) could prevent or delay the onset of type 2 diabetes. The study included overweight/ obese individuals from all racial/ethnic populations who had prediabetes. Participants in the lifestyle intervention group, received intensive training in diet, physical activity, and behavior modification (caloric restriction, lower fat diet and increase of

Trudy Gaillard, PhD, RN, RDE

physical activity to 150 minutes a week). These participants were also instructed on how to lose 7 percent of their body weight. The second group received 850 mg of metformin twice a day. The third group was an placebo arm. The DPP was stopped after 4 year intervention. The DPP demonstrated that lifestyle modification reduced the development of type 2 diabetes by 58% when compared to metformin (31%). This study has become the hallmark of diabetes prevention and should be used as a model for prevention interventions for type 2 diabetes. In fact, the National Diabetes Education Program has designed evidence-based lifestyle intervention tools for preventing type 2 diabetes in the community. These materials are readily available for use and download free of charge from their website. Preventing Diabetes: Knowing your Risk and Numbers Preventing prediabetes and diabetes begins with a knowledge of normal glucose levels. The American Diabetes Association recommends that all adults over 45 years of age be tested for type 2 diabetes. Adults younger than 45 years should be tested if they have additional risk factors, such as overweight/ obese, family history of diabetes, hypertension, belonging to a minority group (African Americans, Asian American, Hispanic American and, Native American ), lack of regular physical activity, having a low high density lipoprotein cholesterol (HDL- or the good cholesterol) and women who have had a baby weight more than 9 pounds or prior gestational diabetes, and have one or more additional risk factors. The American Diabetes Association’s guidelines for diagnosing diabetes outline the following glucose parameters. Normal fasting glucose levels range between 70-100mg/dl, prediabetes: 100-125 mg/dl and greater than 126mg/dl is diagnosed as diabetes. Another test used to diagnosed diabetes is call the hemoglobin A1C, also known as HbA1C or just A1C, which measures the average glucose over a 3 month period. An A1C measure of ≥ 6.5% would be considered diabetes 5.76.4% is considered prediabetes (Table 3). Nursing role in preventing diabetes Nurses play a unique role in assisting individuals to gain adequate knowledge about risk factors for diabetes. Nurses are at the forefront of patient care and can provide strategies related to lifestyle changes as well as become cognizant of the Diabetes Prevention Program and explain to patients that simple changes aimed at 7% weight loss, modest physical activity and caloric restriction can reduce the rate of developing type 2 diabetes by over 50%. The results the DPP should be shared as well as encouraged in all primary care settings as

CONTINUED ON PAGE 7

NBNA-CM&F RN [11.7.13]_NBNA Ad [4.9.08] 11/7/13 10:39 AM Page 1

www.NurseGuard.com

Log On, Download, Email Or Just Call Us For

Fast & Easy, Top-Rated Malpractice Protection: Serving Nurses For Over 65 Years ”A” Rated Insurance Carrier Easy Application Process [5 Minutes Online] Electronic Policy Delivery In 5 Minutes $1 Million/$6 Million Malpractice Coverage 24/7 Occurrence Form Policy One Low Rate For ALL Specialties HIPAA Coverage Included Insured Consent To Settle Coverage Portable Coverage (For Multiple Locations)

As America’s

FIRST provider of malpractice coverages for Nurses (since 1947), CM&F has long been dedicated to your personal asset protection. The potential for a malpractice claim is very real in today’s healthcare and can be financially devastating to nurses of all specialties, which is why having YOUR OWN policy is so important. We make malpractice security easy to get, inexpensive and always backed by the country’s strongest insurers. CM&F is the industry leader in responsive service with FAST online policy delivery and personalized Concierge Customer Assistance. With LOW prices, more features and CM&F’s peerless ® policy and claims services - NurseGuard is the smart choice for another generation of American Nurses!

Licensure Coverage Deposition Expense Protection APPLY TODAY - NurseGuard.com

APPLY TODAY! www.NurseGuard.com 99 Hudson Street, 12th Floor, New York, NY 10013-2815 Tel: 1-800-221-4904 Email: [email protected] VISA/MasterCard

NBNA.org — 7 well as in the community. In addition, understanding the risk factors for prediabetes and type 2 diabetes are important to explain to individuals. Assisting high risk individuals to promote positive behavioral changes to lower risk are the activities that every nurse should embody and support. Nurses are the leaders for change. References:

3. Cowie CC, Rust KF, Byrd-Holt DD, et al. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999–2002. Diabetes Care 2006; 29: 1263–1268. 4. Harris MI, Flegal KM, Cowie CC, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults: The Third National Health and Nutrition Examination Survey, 1988–1994. Diabetes Care 1998; 21: 518–524.

Other resources:

1. http://www.diabetes.org/diabetes-basics/diabetes-statistics/

http://www.diabetes.org/

2. American Diabetes Association. Standards of Medical Care in Diabetesd 2013 doi: 10.2337/dc13-S011 Diabetes Care, January 2013 vol. 36 no. Supplement 1 S11-S66.

http://ndep.nih.gov/diabetes-facts/index.aspx http://www.diabetes.niddk.nih.gov/ http://www.cdc.gov/

Table 1: Risk Factors of Prediabetes and Diabetes Risk Factor

Criteria

Overweight and obesity

Body mass index >25kg/m2

Lack of physical activity

Less than 30 minutes of aerobic activity on most days of the week

Family history

Parent or sibling with type 2 diabetes

Age

Over age of 45 years, increases with age. But the number of children with type 2 diabetes is also increasing.

Race/ethnicity

African Americans, Asian Americas, Hispanic, Native Americans and Pacific Islanders

History of gestational diabetes Women who have had gestational diabetes or who have given birth to a baby that weighed more that 9lbs. Adapted from the American Diabetes Association

Table 2: Metabolic Syndrome Criteria Risk Factor

Citeria

Fasting glucose

≥100 mg/dl

Blood Pressure

≥ 130 / ≥85 mmHg

Waist Circumference

Men > 40 inches Women > 35 inches

Triglycerides

≥ 150 mg/dl

High Density Lipoprotein Cholesterol

Men < 40 mg/dl Women < 50mg/dl

Adapted from the national Cholesterol Education Program- Adult Treatment Panel III (NCEP-ATP III)

Table 3: Diagnosing Prediabetes and Diabetes A1C (%)

Fasting glucose (mg/dl)

Oral glucose Tolerance Test (mg/dl)

Diabetes

6.5 or above

126 or above

200 or above

Prediabetes

5.7-6.4

100-125

140-199

Normal

4-5

99 or below

139 or below

Source: Adapted from American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care. 2013;36 (Supp 1):S11- S66, table 2.

8 — NBNA.org The Benefits and Side Effects of Methadone Versus Suboxone Treatment Modality

O

piates abuse and dependence continue to be major domestic and global issues of concern within the United States and around the world today. “The United Nations reported 12 million heroin users worldwide in 2008” (Maremmani & Gerra, 2010, p.557). Opiates abuse and dependence include pharmaceutical forms of medications such as morphine, oxycodone, vicodon, fentanyl, and so on. In addition, there are the illicit forms of opiates such as opium and heroin, which are highly addictive and prone to substance abuse and dependence as well. There are also other medications such as methadone and suboxone that are used primarily by addiction treatment centers as a harm reduction and abstinence based interventional method that are misused and abused too. This paper’s purpose is to discuss the benefits and side effects of the methadone versus suboxone treatment modalities as medication interventions in the treatment of opiates dependence. Chemical dependency and abuse of opiates continues to be a major health prevention and promotion concern that is affecting our communities at large with increase mortality and morbidity. Methadone Methadone is an opiod analgesic. Methadone is primarily used for detoxification or maintenance in narcotic addiction. It depresses pain impulse transmission at the spinal cord level by interacting with opiod receptors to produce CNS depression (Skidmore-Roth, 2013). Methadone is a full mu opiod agonist that produces morphine- or codeine-like effects on the body. The principal actions of therapeutic value are the analgesic and sedation effects. It binds to opiods receptors in the central nervous system and gastrointestinal tract. Methadone can be taken orally or through injection. Use of Methadone as a Treatment for Addiction The goal in using methadone as a treatment modality is to replace an addictive opiate drug such as heroin or other prescription opiates with a less addictive opiate drug. Methadone treatment has to be given daily and only in a strict clinical environment. It is offered to patients who have chronic, documented opiates dependency. Methadone is generally given orally and dosages are tapered during the treatment process. Methadone dosing is based on two models, the medical model, which is long-term, and the substitution model, which works within a shorter time frame. The medical model approach uses methadone as a method to correct an opiate dependence “by reducing craving and blocking the effects of other opiates” (Wechsberg, Kasten, Berkman, & Roussel, 2007, p.104). As noted, the purpose is to deter the users from using illegal drugs in hope of reducing their risky behaviors and stabilizing their health and social situations. The substitution model uses methadone as an “abstinenceoriented treatment” for a short period to “urge withdrawal,” unlike the medical model (Wechsberg, p.103).

Judy E. Vansiea, MS, MA, RN

The average recommended initial methadone dosage on admission to a clinic is between 30-40 mg as per treatment guidelines and regulations for methadone maintenance treatment (MMT). The regular maintenance dosage in retaining patients in treatment and reducing illicit drug use and criminal behaviors has been between 60-100 mg per day (Wechsberg et al., 2007). Most MMT programs are in large urban areas such as New York City. However, recently more programs have begun operating in smaller cities, suburbs, exurbs, and rural areas as well (Wechsberg et al., 2007). Wechsberg and Kasten (2007) found that over half of MMT patients were of Caucasian origin and were males 35 and older. Next, there was a sizable portion of African Americans (23%) and Hispanics (25%). Half of the patients were employed for more than 35 hours week. Females in the MMT programs were generally found to have higher unemployment rates, primarily due to a lack of marketable skills. The males tend to have more legal and financial problems associated with criminal activities (Wechsberg). Most patients in MMT programs have multiple diagnoses of physical and psychological problems (Wechsberg et al., 2007). Most psychological problems seem to stem from dual diagnoses of chemical dependency and mental illness. Medication intervention alone is not sufficient in the treatment modality of MMT; instead combinations of services are needed, such as medical, counseling, vocational, and educational services. “Studies have shown that the availability of services other than methadone dosing, such as counseling and psychological services, is associated with lower relapse rates and greater retention in treatment” (Wechsberg). Advantages and Disadvantages of MMT Programs Some of the advantages of the MMT programs are: allowing addicts to avoid withdrawal symptoms, at least temporarily; allowing addicts to obtain medication in a safe environment as opposed to getting it on the streets; aid in eliminating health risks such as HIV/AIDS and hepatitis that are more associated with the intravenous administration of heroin; doses can be controlled and gradually reduced as treatment proceeds; and methadone treatment is usually more inexpensive than most alternative methods. The disadvantages of MMT programs are: methadone is highly addictive and so patients run the risk of substituting one addiction for another; social and psychological issues may not be on the hierarchy list during treatment in comparison to actually administering methadone as the number one treatment modality; methadone treatment can be indefinite as long as

CONTINUED ON PAGE 9

NBNA.org — 9 the medical need for it exists; withdrawal from methadone lasts longer than withdrawal from heroin or oxycodone and the withdrawal process is an intense one; and most of the patients have to visit the clinic every day to get their medicine because of legal restrictions. Home Treatment of Methadone There is an exception to the rule against self-administration of methadone, but this can only be allowed as a result of a number of months and years of being on and complying with a MMT program. Overall, take-home privileges are only given in certain conditions, such as the facility is not operating on Sunday. Most MMT programs operate on a 7-day a week schedule. FDA regulations stipulate that patients have to meet certain criteria to be approved for self-administration: an absence of substance abuse, including other opiods and alcohol; regular clinic attendance; absence of behavioral problems at the sites; absence of known criminal activities; stability of home and social relationships; proper storage of meds at home; assurance that rehabilitative benefit to patients outweighs the risk of diversion; and lastly length of time in the MMT, as stated previously (Wechsberg et al., 2007). The permission to take methadone at home usually begins with a 1, 2, 3, or 6 day period, and is then extended up to 30 days, again based on the above-mentioned criteria and length of the MMT. This process is implemented over a gradual trial period each month before getting to a 30-day supply regimen. Thereafter, patients are given a maximum of 31 days of takehome medication, which is renewed after a monthly visit and only when certain goals have been maintained as a patient in the MMT. Suboxone A pharmacologic alternative to methadone treatment is Suboxone treatment, which was introduced for treating opiod intoxication and withdrawal during the late 1970s. The primary active ingredient in Suboxone is buprenorphrine. It is a partial opiod agonist. This means it can both activate and block opiate receptors. Suboxone has another active ingredient called naloxone, which is an opiod antagonist. This drug blocks the effects of an opiate. Naloxone is given for opiods overdosage and in admission into MMT programs as well. Suboxone is primarily used as a maintenance therapy for opiod abusers as a legal long-term alternative to using illicit drugs. Most patients can be stabilized on 12-16 mg of buprenorphine sublingual tablets; but initial dosage on days one and two begins with 8 mg. Then there is a gradual increase of 2-4 mg as needed. Suboxone candidates are generally patients seeking another option to current methadone treatment since they are ready to transition from a low-dose methadone plan to a drugfree state. “Dosage reductions to accommodate a patient’s developments and ultimate cessation of pharmacotherapy is strength unique to buprenorphine” (Ling, 2009, p 613). Advantages and Disadvantages of Suboxone Treatment Suboxone treatment advantages are: it allows addicts to avoid withdrawal symptoms; allows addicts to obtain medication in a safe, clinical environment as opposed to the streets; and has more flexibility regarding being approved for takehome use than methadone. Basically, the naloxone component in Suboxone discourages diversion and abuse unlike

methadone, which is only an opiod agonist. Other Suboxone advantages are: eliminates health risks associated with the IV administration of heroin; dosage is controlled and easily reduced unlike with methadone; monthly visits are easily possibly in treatment in comparison to the daily visits required by most MMT programs; the dosage schedule is 1-4 days, unlike methadone, which is daily and more restricted; and withdrawal is not as intense and there is little if any euphoria associated with it in comparison to methadone. “Maintenance with sublingual buprenorphine has the potential for greater acceptance than methadone because (1) buprenorphine produces less intense physical dependence than a full opiate agonist, (2) it is safer if ingested alone in an overdose, and (3) it can be prescribed from a physician’s office.” (Wesson & Smith, 2010, p. 170). Finally, Suboxone usage has “less cold turkey” effects and is better in preventing a relapse. Suboxone disadvantages are: people still believe that one addiction is being traded for another as with methadone treatment; not enough focus is placed on the social and psychological issues involved with the patients, as also with methadone; withdrawal can last two weeks although it is not as intense as with withdrawal from other opiod agonists, being much more beneficial than methadone treatment in that area; and the cost of the drug treatment modality is more costly than methadone. Comparing Methadone and Suboxone Treatments “Buprenorphine confer on it a high clinical safety profile and its tight receptor binding ensures a relatively long duration of action” (Ling, 2009, p.612). The bottom line is that both methadone and suboxone treatments are two better options than using illicit drugs. Methadone clinics continues to be one of the oldest opiates dependence treatment option for addicts utilizing a harm reduction approach versus Suboxone being an ultimately abstinence based approach. There is a much higher rate of relapse with methadone than with suboxone due to the tendency of many people in MMT programs to take advance of the program’s leniency, return to using illicit drugs, and then returning to methadone again. Addicts know that MMT is there for them as a long-term program, so some may take advantage of the situation. Therefore, this can easily validate why methadone may at times have a stigma attached to its treatment use. On the other hand, suboxone treatment may “add to the value of methadone by increasing access to care” (Maremmani & Gerra, 2010, p.566). Also, “this may make buprenorphine a more appropriate choice for patients who have not been stabilized on maintenance regimen, for those who are at high risk for misusing their maintenance drug, for those with serious comorbidities, and for pregnant women” (Maremmani & Gerra, 2010, p.566) Conclusion In conclusion, the goal of opiates substitution medications such as suboxone and methadone should be to provide a drug-free lifestyle while minimizing the possibilities of cross addiction dependency. Every human being has unique body chemistry and each person body reacts to and tolerates drugs in different ways, so this needs to be kept in mind when choosing the right drug treatment regimen.

CONTINUED ON PAGE 10

10 — NBNA.org Methadone vs Suboxone... contined from page 8

Wakhlu, S. (2009). Buprenorphine: A review. Journal of Opiod Management, 5(1), 59-64.

With either program there should also be more alternative treatments integrated into the treatment plan, such as: group therapy; support groups such as Narcotic Anonymous; faithbased counseling; and vocational, educational, and psychiatric therapy in conjunction with medication management. Medication therapy alone is not a sufficient factor in combating and preventing drug addictions. Instead it should be viewed as one of the primary building blocks used in conjunction with the non-pharmaceutical treatment regimens listed above in order to sustain recovery.

Wechsberg, W. M., Kasten, J. J., Berkman, N. D., & Roussel, A. E. (2007). Methadone maintenance treatment in the U.S.: A practical question and answer guide. New York: Springer.

References Ling, W. (2009). Buprenorphine for opiod dependence. Expert Reviews Neurother, 9(5), 609-616. Maremmani, I., & Gerra, G. (2010). Buprenorphine-based regimens and methadone for the medical management of opiod dependence: Selecting the appropriate drug for treatment. American Journal on Addictions, 19(6), 557-568. Skidmore-Roth, L. (2013). Mosby’s nursing drug reference (26th ed.). Philadelphia, PA: Mosby.

Wesson, R., & Smith, D. (2010). Buprenorphine in the treatment of opiate dependence. Journal of Psychoactive Drugs, 42(2), 161-175.

Judy E. Vansiea, MS, MA, RN, is a member of the Minnesota Black Nurses Association. She is a full-time second year doctoral student in the Doctor of Nursing Practice program in Transcultural Nursing and Leadership at Augsburg College. Judy has been an RN for 16 years and worked in various areas of nursing including medical/surgical, mental health, workers compensation, school nursing, outpatient clinics, nursing education, staff development, and an adjunct faculty member. Judy is a Gulf War veteran. Judy obtained the Master of Science in Psychiatric Mental Health Nursing from State University of New York at Stony Brook and a Master of Arts in Addiction Counseling from Hazelden Graduate School of Addiction Studies.

TENURED/TENURE-TRACK FACULTY POSITIONS AT WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING Washington State University College of Nursing provides high quality and accessible education to baccalaureate, master’s, DNP, and PhD students. The college is seeking applications for Tenure & Tenure-Track Faculty. Health science researchers and educators with an earned PhD (at time of hire) in Nursing, Psychology, Public Health, Medicine or Research in Health Sciences, particularly individuals prepared as APNs with specialization as a Family Nurse Practitioner, Psychiatric Mental Health Nurse Practitioner or in Community/Population Health. Job duties include teaching, research, and service. Position is located in Spokane, Washington, at the rank of Assistant Professor, Associate Professor, or Full Professor. Salary, rank, and tenure status are dependent upon experience and qualifications. This posting may be used to fill multiple positions.

>>To apply visit www.wsujobs.com The online application requires: 1) a cover letter discussing education and experience as related to the required and desired qualifications 2) curriculum vitae 3) names and contact information for four professional references Positions will remain open until suitable candidates are identified. Screening begins immediately. This posting may be used to fill multiple positions. Position is available January 1, 2014 or August 16, 2014. WASHINGTON STATE UNIVERSITY IS AN EEO/AA/ADA EDUCATOR AND EMPLOYER.

nursing.wsu.edu

NBNA.org — 11 Implementing Effective Strategies of Parity to Improve Mental Health Outcomes

T

he 16th Surgeon General, David Satcher’s first report on Mental Health and Mental Disorders in the United States, indicates that “mental health costs account for more than 15 percent of the overall burden of disease from all causes and slightly more than the burden associated with all forms of cancer” (Murray & Lopez, 1996). The Global Burden of Disease study, conducted by the World Health Organization, the World Bank, and Harvard University, reveal that mental illness, including suicide, ranks second in the burden of disease in established market economies, such as the United States. As a result, in the foreword of the report, Satcher states “Promoting mental health for all Americans will require scientific know-how, but even more importantly, a societal resolve, that we will make the needed investment.” New rules enacted to govern mental health care will improve access to care and treatment for 62 million Americans, and will aid in lifting the long-standing stigma related to mental health and related health care services. Enactment of the 2008 mental health parity law requires that insurance coverage must provide the same benefit coverage for mental health and its related services that have been provided for every other kind of illness. While mental disorders are common in the United States, their burden of illness is particularly concentrated among those who experience disability due to Serious Mental Illness (SMI). Data presented in the National Survey on Drug Use and Health (NSDUH) defines SMI as: n Mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) n Diagnosable currently or within the past year n Has a sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) n Results in serious functional impairment, which substantially interferes with or limits one or more major life activities Collectively, African Americans and other minorities within the United States are disproportionately affected with mental illness. Through the research and strides that have been made in mental disorders, 80-90% of these disorders are treatable. However, less than half of the adults with mental illness seek and receive treatment and less than one third of children receive treatment. The lack of seeking or receiving treatment is due in part to the stigma that surrounds mental disorders. The Way Forward In relation to years of life lost to premature death and disability of specified severity and duration (Murray & Lopez, 1996), major depression is equivalent in burden to blindness. A 1996 survey revealed that while Americans had achieved greater scientific understanding of mental illness, the increases in knowledge did not defuse the social stigma (Phelan et al., 1997). The public has learned to define mental illness and to distinguish it from ordinary worry and unhappiness. It has expanded its definition of mental illness to encompass anxiety, depression, and other mental disorders.

C. Alicia Georges, National Black Nurses Foundation (CAG, KGP) Kermit G. Payne, Georgia State University Marie L. Cameron, Robinson College of Business (MRC)

At the same time, the public generally appears to support payment for treatment, but its support diminishes upon the realization that higher taxes or premiums would be necessary (Hanson, 1998). This recognition that improved access may include increased financial support for treatment of mental health related disorders is viewed casually. But of greater significance, is the roles that faith based groups have in addressing mental health improvements. The faith-based community, in partnership with policymakers and academic and clinical communities can provide the necessary safety net to enhance mental health and its related services. There is growing evidence that demonstrates the value of the faith-based community, and its contributions of comfort, solace and hope to people with mental illness. The presence of faith, spirituality and religion are positively positioned to impact mental health disease recovery, develop coping skills, and improve mental health outcomes through newly enacted policy interventions. A heightened sense of community, cultural competence, religious and other spiritual practices supported by an understanding of mental illness and psychiatric disabilities will promote mental health recovery. However, social factors continue to hinder recovery and reduce the level of assistance- from the faith-based community or others in roles of authority. These barriers highlight the important need for social policy discussions, training for community and faith based leaders as well as consumers. At all levels, advocacy efforts must marshal intellectual, political, and economic forces to effectively implement opportunities of parity for mental health consumers and those who give and care for them.

12 — NBNA.org Recognizing Distress in Patients with Cancer Fedricker D. Barber, PhD, RN, ANP-BC, AOCNP

P

atients with cancer may experience multiple physical and emotional symptoms secondary to the cancer diagnosis, including altered body image, treatment-related side effects, or disease progression (Chen & Lin, 2007; Fan, Filipczak, & Chow, 2007). One symptom that often goes undiagnosed is distress (Jones & Doebbeling, 2007). Estimates of distress in patients with cancer vary widely—from 2% to 46%—compared with an estimate of 6.7% in the general population (Mitchell et al., 2011; Rouanne et al., 2013). Patients with lung cancer tend to have higher rates of distress (43%) than do patients with gynecologic cancers (29%), whereas patients with lymphoma or cancers of the pancreas, liver, colon, brain, or prostate tend to have lower rates of distress in general (7%–9.7%) (Massie, 2004; Zabora, BrintzenhofeSzoc, Curbow, Hooker, & Piantadosi, 2001). The prevalence of distress among patients with cancer may vary owing in part to an overlap of somatic and distress symptoms, the reluctance of patients to disclose emotional problems, or the inadequate screening of patients. For example, a study that evaluated psychiatric disorders and the use of a mental health service in patients with advanced cancer found that fewer than 10% of such patients were identified and referred to mental health services (Kadan-Lottick, Vanderwerker, Block, Zhang, & Prigerson, 2005). Similarly, a study that assessed the prevalence of distress among low-income, ethnic minority women with breast cancer or gynecologic cancer found that 24% of these patients reported moderate to severe distress, yet only 5% of them reported receiving antidepressants or being referred to mental health services (Ell et al., 2005). Distress has been associated with decreased sexual function, moderate to severe cognitive impairment, poor physical functioning, and suicidal ideation (Akechi, Okamura, Yamawaki, & Uchitomi, 2001; Mystakidou et al., 2013; Rouanne et al., 2013). Additionally, distress is associated with a poor health-related quality of life, poor treatment adherence, and decreased overall survival rate compared to patients who do not manifest distress (Arrieta et al., 2013). Thus, new and improved methods to screen for distress and better access to psychosocial services for patients with cancer are clearly needed and are foci of ongoing modifications in national accreditation and distress management guidelines. Screening for Distress To facilitate distress screening and improve access to psychosocial services for patients with cancer, the American College of Surgeons has included distress screening as one of its’ standards for accreditation for oncology centers (Wagner, Spiegel, & Pearman, 2013). In addition, the National Comprehensive Cancer Network has recommended guidelines to assist health care providers in screening for and managing distress in cancer patients (Holland et al., 2013). Symptoms of Distress n Fear and worry about the future n Concerns about illness n Sadness or anger about loss of usual health

n

Insomnia Anorexia n Poor concentration n Preoccupation with thoughts of illness and death n Concern about social roles n

Risk Factors for Distress Several risk factors for distress in cancer patients have been identified: a history of psychiatric disorders or substance abuse, cognitive impairment, severe comorbid illnesses, uncontrolled symptoms or side effects, and communication barriers. Preexisting social problems such as family/caregiver conflict, poor social support, living alone, financial issues, or a history of physical/sexual abuse have been shown to increase the risk of distress (Holland et al., 2013). Treatment Multiple nonpharmacologic and pharmacologic treatments are available for patients who exhibit distress. Common nonpharmacologic treatments include group psychotherapy, problem-solving techniques, supportive counseling, and cognitive-behavioral therapy (Holland et al., 2013). In addition, unsupervised and supervised physical activity programs have been shown to have positive effects on distress in patients with cancer (Craft, Vaniterson, Helenowski, Rademaker, & Courneya, 2012). Patients with moderate to severe distress may benefit from low-dose antidepressants or low-dose antianxiety medication (Holland & Alici, 2010). Conclusion Patients with cancer tend to experience a variety of physical and emotional symptoms that may cause distress. Early screening for, assessment of, and treatment of distress in these patients will facilitate their referral to appropriate mental health resources, an event that might improve these patients’ quality of life and enhance their adherence to treatment, thus improving clinical outcomes. Additional research is needed on nursing interventions that improve the assessment and treatment of distress in minority, pediatric, and elderly patients with cancer. References Akechi, T., Okamura, H., Yamawaki, S., & Uchitomi, Y. (2001). Why do some cancer patients with depression desire an early death and others do not? Psychosomatics, 42(2), 141-145. doi: 10.1176/appi. psy.42.2.141 Arrieta, O., Angulo, L. P., Nunez-Valencia, C., Dorantes-Gallareta, Y., Macedo, E. O., Martinez-Lopez, D., Onate-Ocana, L. F. (2013). Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Ann Surg Oncol, 20(6), 1941-1948. doi: 10.1245/ s10434-012-2793-5

CONTINUED ON PAGE 15

NBNA.org — 13 Disparities in Pediatric Dental Health in Vulnerable Populations

Gwendolyn Jones, RN, MSN

Program Manager, College of Health Sciences & Nursing University of Phoenix

T

hat there is a disparity in health care services among our most vulnerable populations is indisputable. Access to healthcare and availability of health services to citizens of lower economic status has been well documented. It is particularly necessary to examine the disparity in oral health services for our most at-risk population. In 2000, David Satcher, the Surgeon General, issued a report entitled, Oral Health in America. In this report, he stated that “a silent epidemic of oral diseases is affecting our most vulnerable citizens—poor children, the elderly, and many members of racial and ethnic minority groups.” (Oral Health in America: A Report of the Surgeon General, May 25, 2000). On April 23, 2003, Surgeon General Richard Carmona in his address to the National Head Start Institute in Washington, D.C., stated that the two most prevalent health problems among children in the United States are obesity and lack of dental care. Calling Surgeon General Satcher’s report on Oral Health in America a “wake up call”, Surgeon General Carmona issued a National Call to Action to Promote Oral Health. (National Call to Action to Promote Oral Health; NIH Publication No. 03-5303, Spring, 2003). Vulnerable Pediatric Populations and Dental Health Next to childhood obesity, tooth decay is the second most common chronic disease of childhood in the United States. This health problem is particularly evident among children in low income families. However, the general pediatric population as a whole is affected, albeit not as greatly as poor children. Nationally, an estimated one in three children enrolled in Medicaid has untreated tooth decay, and one in nine has untreated tooth decay in three or more teeth. Children enrolled in Medicaid are almost twice as likely to have untreated tooth decay as children with private insurance. (Pediatrics 2008;121;e286; January 14, 2008) Poor children are particularly vulnerable to untreated tooth decay and lack of access to dental care. “More than 40% of children have tooth decay before they reach Kindergarten. These children come, primarily, from low-income families, who parents have a low educational level and are more likely to consume sugary foods. That puts them at risk to be 32 times more likely to have tooth decay by age three. (Weiss, P., 2003, Oral health risk assessment timing and establishment of the dental home. American Academy of Pediatrics. 111 (5) 1113-1116). What are the reasons for the disparity? There are many. First, there are socioeconomic factors. They include low income and a lack of resources to pay for care, either out-of-pocket or through private or public dental insurance. In addition to socioeconomic factors, there are environmental factors as well. Environmental factors include lack of clean drinking water, particularly in some rural areas, and a lack of fluoridated water in some communities. Water fluoridation is seen as a universal method to prevent tooth decay crossing all demographics. (British

Dental Journal 199, 1-4 (2005) doi: 10.1038/sj.bdj.4812863). The problem is that not all communities have fluoridated water, either due to lack of access or voluntary refusal to accept fluoridated water in their communities. This is not only in the United States, but in other countries as well. Examples of cities that have refused fluoridated water include: Columbia, Tennessee; Portland, Oregon; Davis, California; and Rockhampton, Queensland, Austrailia. (Fluoride Alert.Org; 2013). The difficulty in establishing a dental care home is a serious problem for many children in the U.S. Even when children have access to dental care, many go for initial treatment and do not complete the treatment. Parent do not follow through, mainly because of out of pocket cost, or not understanding the importance of completing the dental treatment. Transient families also have difficulty establishing a dental home. Children of migrant workers or families that move frequently often do not receive adequate dental health care. (Barnet & Meyer, 2002). One of the most profound reasons for disparities in dental health is the lack of understanding of the relationship between dental health and general health. The mouth reflects general health and well-being. Research findings have pointed to possible associations between chronic oral infections and the following health issues: Diabetes; heart and lung diseases; stroke; and low-birth-weight and premature births. (Mayo.com; 2013). Poor dental health has been proven to lead to serious general health problems. It is the inability of the general population to understand the correlation between the two (dental health and general health) that is the problem. “It’s Just A Baby Tooth – Pull It!” The obvious result of poor dental hygiene is tooth decay. This is a significant problem in the pediatric population primarily due to lack of dental education and knowledge of the importance of proper care of the primary teeth, often referred to as “baby teeth”. Many parents believe that care of primary teeth is not important because a child will get a “whole new set”. Many do not understand the function of the primary teeth and their importance. (http://www.childrensdentalhealth. com/about-you/why-baby-teeth, 2013) They have not been educated to the functions of primary teeth which include: speech and language development; proper digestion and nutrition; and they are space holders for permanent teeth. Rather than pull decayed primary teeth, parents in particular should be educated that these teeth need to be restored! Why? If we don’t treat/restore baby teeth, permanent teeth may become infected. Infected baby teeth may transmit cavity causing bacteria to the permanent teeth underneath. Viewing the dental x-ray below, it is evident that there is close proximity of the erupted primary teeth to the permanent teeth still beneath the gums. Untreated tooth decay allows bacteria to travel along the root and may infect the permanent teeth that have yet to erupt.

CONTINUED ON PAGE 14

14 — NBNA.org with drugs and these drugs, such as methamphetamines, slow saliva production and often cause rampant cavities known as “Meth Mouth. (Goodchild, Jason; Donaldson, Mark (2007). “Methamphetamine Abuse and Dentistry: A Review of the Literature and Presentation of a Clinical Case”. Quintessence International 38 (7): 583–590. PMID 17694215.) It is the responsibility of the practitioner to identify and assess the oral health status of these high risk children.

Proximity of primary root to permanent tooth affords easy transmission of decay.

Primary Care Providers Lack Dental Assessment Skills One of the biggest problems in providing pediatric dental care is lack of dental assessment skills by pediatric primary care providers (PCP). In addition, all too often dental assessments are just not done. Dental assessments should be a routine part of pediatric medical care. The primary care provider plays an important role in prevention and control of this disease because of their ready access to the pediatric population. Unlike dentists, the primary care practitioner sees pediatric patients on a more consistent basis throughout the early childhood years. This results in increased opportunity to be able to diagnose dental problems and make the proper referral(s). Recent studies have shown dental assessments are either routinely not performed or inadequately performed by PCPs. Assessing oral health, including a visual exam and risk factor assessment, should be a routine part of well child care for all children. Lift the child’s lip and look at the teeth. This is most important. Many children go through an entire health assessment and the practitioner does not lift their lip and look at the teeth for signs of decay. Healthy teeth are shiny and smooth. The earliest signs of decay may appear as a white spot or general loss of reflectiveness of the enamel, much like looking at frosted glass or flat paint. Brown or yellow spots or carious lesions on the teeth are more obvious symptoms of tooth decay. The PCP must also be aware of and identify high risk children. These include children who have diets high in sugar, children who drink a lot of juices, or who snack frequently. They are at greater risk of caries. Medically compromised children, including those with low birth weight and children with special need fall into the high risk category. Another consideration for the PCP to factor in regards children taking sugar-based medications or medications that affect salivary flow. This also puts children at great risk for cavities as increased sugar intake leads to caries. Saliva helps keeps the mouth healthy and ingestion of medications that inhibit salivary flow may increase the likelihood of cavity formation. Keep in mind the pediatric population also includes adolescents. Many teens experiment

What Can Nurses Do? One of the primary responsibilities nurses have is patient advocacy. Those nurses working directly with the pediatric population must be aware of and advocate for providing oral health assessments and care for these patients. Nursing roles are very diverse and are seen in a variety of settings. Advanced Practice Nurses (APNs) such as Pediatric Nurse Practitioners and Family Nurses Practitioners, as primary care providers, have direct exposure to pediatric patients. They see them regularly in the first two to three years of life. Therefore, there is much opportunity to provide oral assessments, referrals, and care for these patients. Pediatric Nurses, Public Health Nurses, School Nurses also have access to these patients. They too must be aware of and call attention to the necessity of an oral assessment. If a nurse works in a pediatric office, for example, and notes that children are not routinely receiving an oral assessment during their well child check-ups, it is incumbent upon that nurse to call this to the pediatrician’s attention. Sometimes practitioners too are guilty of minimizing the importance of oral health on general health, or due to time constraints, may not perform an exam that includes an oral assessment. By educating their colleagues, nurses have the opportunity to make a difference in the health of our children. Besides health care providers, pediatric dental health education is needed by parents, children when they are old enough, and the general public. Parents, as primary caretakers of their children, need to know how to promote good dental health and what signs are indicative of dental ill health. There are some basics that parents should be made aware of. They include such preventative measures as: n Limiting sugar intake. n Never putting an infant to bed with a bottle OR if a bottle is given, it should only contain water. n Do not taste or chew food for infants before feeding them. Germs from the adult mouth can be transferred to the child. n Lift the lip! Encourage parents to check their child’s teeth monthly to look for signs of decay. n Take the baby to the dentist. “First dental visit by first birthday” particularly for high-risk children. All children should see a dentist by age three. n Daily oral care. Clean infant gums and first teeth with a moist cloth after each feeding. Parents should assist their child with brushing until age 6. Health care providers must do a better job of caring for our children’s dental health. The evidence that poor dental health is linked to many general health illnesses and diseases is clear. If practitioners are made more aware of the importance of providing adequate oral healthcare, making oral assessments a regular part of pediatric exams, and making the proper referrals to pediatric dentists when problems are found, our children would greatly benefit.

CONTINUED ON PAGE 15

NBNA.org — 15 Dental Health... contined from page 14 References American Academy of Pediatrics. A Pediatric Guide to Children’s Oral Health. Barnet, A. & Meyer, G. (2002), Filling students’ dental needs. Education Digest. 68 (2), 58-62 Elk Grove Village, IL: American Academy of Pediatrics; 2009 Retrieved from: http://www.kokkinosmileclinic.com/primary_teeth. php; June 24, 2013 Oral Health in America: A Report of the Surgeon General, May 25, 2000. Pediatrics, the official journal of the American Academy of Pediatrics, was a study by Kate M. Pierce, R. Gary Rozier and William F. Vann, Jr., 2000 Preventive Oral Health Intervention for Pediatricians, Pediatrics 2008; 122; 1387. Singer, R., 2013 www.mykidshometowndentist.com Retrieved from: http://www.saugusdental.com/glossary/c/childrensxrays. July, 2013. Retrieved from: http://www.winningwithsmiles.com/early-childhoodcaries-ecc.html

adjustment disorder in oncological, haematological, and palliativecare settings: a meta-analysis of 94 interview-based studies. Lancet Oncol, 12(2), 160-174. doi: 10.1016/s1470-2045(11)70002-x Mystakidou, K., Parpa, E., Tsilika, E., Panagiotou, I., Zygogianni, A., Giannikaki, E., & Gouliamos, A. (2013). Geriatric depression in advanced cancer patients: the effect of cognitive and physical functioning. Geriatr Gerontol Int, 13(2), 281-288. doi: 10.1111/j.1447-0594.2012.00891.x Rouanne, M., Massard, C., Hollebecque, A., Rousseau, V., Varga, A., Gazzah, A., . . . Soria, J. C. (2013). Evaluation of sexuality, healthrelated quality-of-life and depression in advanced cancer patients: a prospective study in a Phase I clinical trial unit of predominantly targeted anticancer drugs. Eur J Cancer, 49(2), 431-438. doi: 10.1016/j.ejca.2012.08.008 Wagner, L. I., Spiegel, D., & Pearman, T. (2013). Using the science of psychosocial care to implement the new american college of surgeons commission on cancer distress screening standard. J Natl Compr Canc Netw, 11(2), 214-221. Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001). The prevalence of psychological distress by cancer site. Psychooncology, 10(1), 19-28.

Dr. Barber is a nurse practitioner at The University of Texas MD Anderson Cancer Center. She is a lifetime member of the National Black Nurses Association and a member of the Fort Bend County Black Nurses Association.

Distress in Cancer Patients... contined from page 12 Chen, M. L., & Lin, C. C. (2007). Cancer symptom clusters: a validation study. J Pain Symptom Manage, 34(6), 590-599. doi: 10.1016/j.jpainsymman.2007.01.008 Craft, L. L., Vaniterson, E. H., Helenowski, I. B., Rademaker, A. W., & Courneya, K. S. (2012). Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev, 21(1), 3-19. doi: 10.1158/10559965.epi-11-0634 Ell, K., Sanchez, K., Vourlekis, B., Lee, P. J., Dwight-Johnson, M., Lagomasino, I., Russell, C. (2005). Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer. J Clin Oncol, 23(13), 3052-3060. doi: 10.1200/jco.2005.08.041 Fan, G., Filipczak, L., & Chow, E. (2007). Symptom clusters in cancer patients: a review of the literature. Curr Oncol, 14(5), 173-179. Holland, J. C., & Alici, Y. (2010). Management of distress in cancer patients. J Support Oncol, 8(1), 4-12. Holland, J. C., Andersen, B., Breitbart, W. S., Buchmann, L. O., Compas, B., Deshields, T. L., Freedman-Cass, D. A. (2013). Distress management. J Natl Compr Canc Netw, 11(2), 190-209. Jones, L. E., & Doebbeling, C. C. (2007). Suboptimal depression screening following cancer diagnosis. Gen Hosp Psychiatry, 29(6), 547-554. doi: 10.1016/j.genhosppsych.2007.08.004 Kadan-Lottick, N. S., Vanderwerker, L. C., Block, S. D., Zhang, B., & Prigerson, H. G. (2005). Psychiatric disorders and mental health service use in patients with advanced cancer: a report from the coping with cancer study. Cancer, 104(12), 2872-2881. doi: 10.1002/cncr.21532 Massie, M. J. (2004). Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr(32), 57-71. doi: 10.1093/ jncimonographs/lgh014 Mitchell, A. J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C., & Meader, N. (2011). Prevalence of depression, anxiety, and

Eastern Michigan University Assistant Professor, School of Nursing The School of Nursing invites applications for a tenure-track position; the appointment will be at the rank of Assistant Professor with a start in Fall 2014. The School of Nursing is one of four schools in the College of Health and Human Services. The School offers both undergraduate program options and a graduate program in adult health nursing. A Ph.D. in Educational Studies with a concentration in Nursing Education in collaboration with the College of Education is also offered. EMU enrolls approximately 23,000 students and offers an outstanding benefits package and a collegial work environment. EMU's distinct mix of comprehensive academic resources, strong community initiatives, focus on Education First, and nationally-recognized undergraduate and graduate student research achievements set it apart. The EMU campus is located in the Ypsilanti/Ann Arbor community, five miles from downtown Ann Arbor and 35 miles west of Detroit, MI and Windsor, Ontario. Qualifications include: Master’s degree in nursing or an appropriate allied health field; Completed 18 credit hours toward doctorate in addition to Master’s (Applicants without 18 credit hours of doctoral study may be considered at Instructor level rank); Current or eligible for Registered Nurse license in the State of Michigan; At least 4 years of combined teaching and clinical experience; Evidence of scholarly activities commensurate with rank. Preference is given for applications that demonstrate: Master’s specialization in any of the following clinical specialty practice areas; Psychiatric/Mental Health, Pediatrics, Adult Health, or Community/Public Health; Advanced Practice Nurses (Nurse Practitioners) are encouraged to apply; Doctoral degree attainment in Nursing or a related field; Evidence of professional and/or community service. All applications must be made online at https://www.emujobs.com. Applications must include letter of application and CV/resume. Applicants must clearly indicate in their cover letter if they hold a clinical master’s (specialty) and if they are certified or test eligible as a nurse practitioner or clinical nurse specialist (specialty). Applicants currently enrolled in a terminal degree program (Ph.D., Ed.D., DNP) should include the number of credit hours that they have completed at the time of application and their projected date of completion in the CV/resume. Review of applications will begin immediately and continue until the position is filled. For more information, contact the Search Committee Chair: Sherry Bumpus, Ph.D., MSN, RN, FNP-BC, Assistant Professor, School of Nursing, (734) 487-2279. Eastern Michigan University is an Affirmative Action/Equal Opportunity Employer that is strongly committed to achieving excellence through cultural diversity.

NBNA Newsletter Size: 1/4 page (3.25” x 5”) Issue : Fall

Pen n State | On lin e w w w. w o r l d c a m p u s . p s u . e d u

Advance Your Career Penn State’s College of Nursing Online Programs

Prepare for career advancement, supervision, administration, or your specific field of interest. Choose from one of Penn State’s online nursing programs and study whenever, wherever you want: Master of Science in Nursing RN to B.S. in Nursing Undergraduate Certificate in Nursing Management Undergraduate Certificate in Nursing Informatics Undergraduate Certificate in Nursing Forensics

Achieve your goals— apply today!

w w w.wo rl d ca m p us . p s u.e d u/n b n a Penn State College of Nursing This program is fully accredited by the Accreditation Commission for Education in Nursing, Inc., 3343 Peachtree Road, NE, Suite 850, Atlanta, GA 30326, 404-975-5020; the Commission on Collegiate Nursing Education, One Dupont Circle, NW, Suite 530, Washington, DC 20036, 202-887-6791; and is approved by the Pennsylvania State Board of Nursing. U.Ed.OUT 14-0250/14-WC-0369ajw/bjm

NBNA.org — 17 Promoting Health: Genetic Research and Opt-Out Consent Yolanda M. Powell-Young, PhD, PCNS-BC

Associate Professor, Dillard University, New Orleans; Visiting Professor, The University of Iowa, Iowa City, IA

Ida J. Spruill, PhD, LISW, FAAN

Associate Professor, Medical University of South Carolina, Charleston, SC

T

he emergence of genetics as central to advancing a healthy America is acknowledged by the recognized inclusion of “genetics” as a health topic in the Healthy People 2020 national wellness agenda (www.healthypeople.gov). However, to properly understand how genetic discoveries influence population health, treatment and wellness interventions, the inclusion of members from ancestral minority groups and their subpopulations is essential. One of the most difficult aspects of conducting genetic research is the recruitment of ancestral minorities for study inclusion. Researchers indicate that African Americans and other peoples of color are generally less likely to participate in biomedical research (Murphy & Thompson, 2009). The perception of mistrust is an often-cited reason for lack of research participation by African Americans. Low participation rates or non-participation in genetic research among minority populations in general and African Americans specifically, disadvantages the scientific pursuit to prevent and reduce racial and ethnic health disparities. One recruitment strategy that is gaining attention for its capacity to capitalize on the availability of large cohorts of ancestrally diverse individuals as prospective study participants is termed opt-out consent. As an alternative to the gold standard informed consent process, the opt-out model is associated with a considerably lower refusal rate. Thus, it is typically deemed a beneficial strategy for increasing study sample diversity. At its most basic, “To be informed, consent must be given by persons who are competent to consent, have consented voluntarily, are fully informed about the research, and have comprehended what they have been told” (Chambliss and Schutt, 2010, pp.57-8). The informed consent process is the critical communication link between the prospective human subject and an investigator, beginning with the initial approach of an investigator to the potential subject and continuing until the completion of the research study. Simply put, the informed consent process should involve an education and information exchange between the investigator and prospective participant. In contrast, the opt-out consent model is a presumed consent that works on the premise of inclusion unless an individual specifically indicates that they do not want to participate. In certain instances, neither a full exchange of information nor evaluation of comprehension is a model requisite. As such, a major objection to the utilization of this model argued by some in the scientific community is the potential for restricted autonomy; a fundamental principal upon which the framework of informed consent was founded. The value of autonomy becomes more important when genetic material is involved, and particularly in light of perpetuity provisos. Meaning once an individual’s

DNA source material (e.g., blood, tissue) is obtained, it can be used eternally without further donor permission. Others argue that materials garnered through opt-out protocols may not fall within the definition of human subjects and therefore, do not fall within the purview of the doctrine of informed consent (Pulley, Clayton, Bernard, Roden, & Masys, 2010). The opt-out model of consent is currently in use at several academic affiliated medical institutions in the United States. These institutions have historically provided care to the medically indigent, many of whom are of diverse, non-European ancestry. Currently the inclusion of opting-out consent appears to be more prevalent with bio-repository and bio-specimen research. For example, Vanderbilt University Medical Center advocates opt-out consenting and currently utilize this model as part of their bio-repository recruiting protocol. Public awareness and understanding of the opt-out consent process has been limited. African American nurses are in a unique position to proactively educate prospective genetic study participants and other potential consumers of genetic services about the essentials of opt-out consenting. With education comes the potential for positive and sustainable health promotion and prevention outcomes. For example, the opportunity to timely inform the members of our communities may help to mitigate the feelings of profound mistrust that African Americans often hold toward the scientific community. More importantly, African American nurses are in a position to communicate the significance of genetics research and its impact on African American health. By taking an active role in forwarding positive changes toward health and wellness within our communities NBNA nurses continue to significantly advance the mission and goals of the organization. References Chambliss, D. F. and Schutt, R.K. (2010). Making sense of the social world: Methods of investigation (3rd ed.). PineForge Press: Thousand Oaks, CA Murphy, E., & Thompson, A. (2009). An exploration of attitudes among Black Americans towards psychiatric genetic research. Psychiatry, 72(2), 177-194. Pulley, J., Clayton, E., Bernard, G.R., Roden, D.M., and Masys, D.R. (2010). Principles of human subjects protections applied in an opt-out, de-identified biobank. Clinical and Translational Science, 3(1), 42-48. doi: 10.1111/j.1752-8062.2010.00175.x

18 — NBNA.org Emerging Focus on Mental Health Provides Key Resources for Care Providers Steven Dashiell, Dorland Health

M

ental healthcare has arguably been underserved for many years now, owing much of the neglect to the healthcare industry’s fee-for-service approach to treating patients. However, the pendulum has begun swinging in the other direction recently, thanks to a few public spotlights on the issue of mental health. The string of shootings earlier this year, such as Sandy Hook and Aurora, introduced a lot of contention over not just gun control, but the need for better access to mental health services and screening. The Affordable Care Act and healthcare reform as a whole also have drawn attention to mental health care as part of the overall goal of improving quality of care and increasing focus on long-term, preventive, patient-centered care. Mental health issues, such as depression and anxiety, often contribute to chronic health issues, which account for a large percentage of overall costs for the healthcare industry. The White House blog recently released an article that acknowledges the need for greater mental health coverage and points to the Affordable Care Act as an important measure in achieving this goal. This blog follows up on last year’s National Conference on Mental Health, where the President proposed to increase mental health awareness and education for teachers and other adults who interact with students and children. Other proposals include supporting state-based programs to improve mental health outcomes for the younger population and the training of an additional 5,000 mental health professionals, with an emphasis on serving students and young adults. According to the White House blog, there are three important ways that the government is addressing mental health care by means of the Affordable Care Act: n Mental health and substance use disorder benefits and parity protections for roughly 62 million Americans will be expanded. n Most health plans must now cover preventive services at no cost. Examples include depression screening for adults and behavioral assessments for children.

n

With the launch of the Affordable Care Act in 2014, plans will not be able to deny coverage or charge more due to pre-existing health conditions, including mental illness. Last year’s National Conference on Mental Health also promised to open a “community conversation” on the issue of mental health, and part of that promise was the release of MentalHealth.gov, a website dedicated to providing information and resources to the public on mental health issues and ways of getting help. The information detailed on the White House blog could originally be found at this site, along with a plethora of other essential articles and links dedicated to mental health, including the definition of mental health; common myths and facts; symptoms and behaviors to look for amongst the various types of disorders; advice for those suffering from mental health issues as well as those who support such individuals; and links to help, such as emergency hotlines and clinical trials. With health insurance marketplaces opening in just over a month’s time, this blog entry falls in line with the increased visibility and marketing that can be expected for the Affordable Care Act as the year ticks down to 2014, as well as the goals set forth during the National Conference on Mental Health. With the focus on preventive, quality care becoming increasingly important in the months to come, case managers should carefully evaluate where mental health issues and long-term care fit into their current approach and begin making plans to adjust accordingly. Patients and caregivers can also be directed to the MentalHealth.gov site in order to learn how to best monitor and take care of mental health issues on a dayto-day basis. Health and financial outcomes will benefit over the long term, but education and preparation must come first.

Reprint permission by Dorland Health Reprint from http://www.dorlandhealth.com/clinical_care/trends/ Emerging-Focus-on-Mental-Health-Provides-Key-Resources-forCare-Providers_2900.html

NBNA.org — 19 The Sexting Phenomenon – What Do We Know? What Do We Need to Know? Betty J. Braxter, PhD, RN, CNM Assistant Professor for Nursing at the University of Pittburgh School of Nursing

C

ell phones have become a part of the daily landscape. Approximately 87.4% of the United States population owns a cell phone (Federal Trade Commission) according to Julius Genachowski’s report before the United States Senate Committee on Commerce, Science, and Transportation (2009). Among adolescents, seventy-five percent of teens ages 12 -17 years own a phone (Lenhart, Ling, Campbell, & Purcell, 2010). Some cell phones allow teens to send and receive text messages, the number one form of communication among the group (Lenhart, 2012), connect to the internet, play games, and less frequently send and receive email. Additionally, with expanding functionality, most cell phones also now serve as digital cameras. With the camera phone, teens are able to send pictures. Camera phones have been used by teenagers to capture important events in their lives (i.e., prom, high school graduation). Teens have even used camera phones to capture the pictures of attackers. In Bridgewaters, Conn, a student used his camera phone to capture three middle school students beating up another student (Stoutt, 2011). For adolescents, the use of cell phones can be associated with legal, sexual and psychological risks. With the cell phone, teens are able to send sexually explicit messages that are distributed to other cell phone users or posted on the internet. With a quick click, a teen’s nude or nearly nude body can be sent to everyone in her or his web address book, and posted on MySpace or Facebook (Webb, 2009). A national survey by Cox Communication and the National Center for Missing and Exploited Children (NCMEC) in 2007 found that MySpace was one of the two most popular sites for teens to post pictures (Cox Communications, 2007). The sending of an explicit sexual message or nude/nearly nude photo is referred to as sexting. As defined in the United States versus Broxmeyer case, “sexting is the exchange of sexually explicit text messages, including photographs, via cell phone” (United States versus Broxmeyer, 616 F.3d 120[2d cir, 20]). A recent national survey by the Pew Foundation revealed that a number of teens (15%) have received nude or nearly nude pictures of someone they knew. Approximately 4 % of teens reported they had sent nude or nearly nude pictures of themselves to another person (Lenhart et al., 2010). A media survey conducted by Cox Communications (2009) for public use reported that 22% of teens had sexted someone they had a crush on; 19% sexted a boyfriend/ girlfriend; and 11% had sexted someone they did not know. Legal Issues related to Sexting Child pornography is described as the creation, possession, or dissemination of nude or seminude pictures of children (www.missingkids.org; retrieved July 21, 2011) and is illegal in the United States. The National Conference of State Legislatures (NCSL) in 2010 reported that about 16 states had

introduced or were considering some type of legislation targeting sexting (www.ncsl.org; retrieved July 21, 2011). Legislation typically focuses on education related to the risks of sexting. Legal consequences associated with sexting vary from state to state. In New Mexico, a teen may be prosecuted as a felon for sexting and may be required to register as a sex offender under child pornography laws. In contrast, a teen engaged in sexting in Illinois will face a misdemeanor offense and may be required to participate in a number of hours of community service. Health Issues related to Sexting In addition to the legal consequences associated with sexting, an emerging body of work also suggests varied health, and sociological/psychological consequences. Peskin and Tortolero, professors at the University of Texas School of Public Health, have linked sexting to an increased risk for cyberbullying and sexual harassment (http://www.healthleader.uthouston.edu/; retrieved July 20, 2011). Cyberbullying may result in depression, increased risk of suicide, and poor quality of life among adolescents (Ybarra, 2004; Ybarra, Alexander, & Mitchell, 2005). In a report on the impact of social media on children, adolescents and families, O’Keefe, Clarke-Pearson, and the Council on Communication and Media (2011) suggested individuals who have been targets of unsolicited sexting experience emotional distress and mental health problems. Because sexting is a fairly new phenomenon, the impact on behaviors leading to injuries (i.e., related to automobile accidents) is not known. What is known is that “texting” has been linked to increased automobile accidents (Reed and Robins, 2008). An editorial by Weiss and Samenow (2010) posits sexting may also be linked to an increased risk of automobile accidents. Clinical Implications As the prevalence of sexting continues to increase, health care providers including nurses and nurse practitioners, psychologists, and sociologists need to begin to assess the effect of the behavior on the health and well being of adolescents and young adults. The clinical recommendation presented could be extended to include sexually explicit messages, another type of sexting, as well as pictures. Individuals providing care to the targeted population may want to adopt the “5 A’s” mnemonic associated with smoking cessation interventions by Agency for Healthcare Research and Quality(AHRQ) as a guide – Ask, Advise, Assess, Assist, and Arrange. n Ask if the adolescent has received or sent nude/semi-nude pictures to another person n Advice the adolescent on the legal, psychological, social, and health consequences associated with sexting n Assess the effect of sexting if the adolescent has been victimized n Assist the adolescents in receiving treatment if warranted n Arrange for treatment

CONTINUED ON PAGE 20

20 — NBNA.org Sexting... contined from page 17 Asking about sexting should become one component of an overall adolescent assessment that provides an opportunity for providers to talk with the adolescent more generally about healthy relationships. As individuals who provide services to adolescents, the needs of the childrearing parents should also be addressed. Talking with parents about sexting can be viewed as health education/teaching, and sitting with parents and reviewing appropriate resources (e.g., websites) that provide tips to help parents talk with their child/adolescents about sex/sexting should also be viewed as health education/teaching. Research Implications Weiss and Samenow (2010), in their call for research on sexting, smartphones, and other communication technologies, begin to address areas of inquiry. For example, the authors focus on the effect of sexting as it relates to society’s understanding and description of normal adolescent behavior compared to aberrant behavior and/or criminal behavior. Questions to be addressed could include the following. Does the trajectory for sexting as the behavior moves from what may be considered as within normal to that of aberrant differ by gender, race/ethnicity, or age? Is the type or focus of sexting (e.g., Pictures versus verbal response) different according to gender, race/ethnicity, or age? What is the tipping point that determines sexting is within normal adolescent behavior to that of aberrant behavior? Studies on sexting as related to cyber bullying may be quite relevant given the emerging association between the two behaviors as documented by Perkin and Torturer ( www. healthleader.uthouston.edu/). Other studies on the effect of sexting on the quality of heterosexual relationships or gay/ lesbian relationship could possibly provide another lens for understanding teen dating violence. Finally, as Weiss and Samenow (2010) suggest, research is needed to identify those at risk for developing problems associated with sexting, and what interventions would be best for diverse groups of adolescents. We know that the “one size fits all” approach rarely works given the different sub-populations. References: Agency for Healthcare Research and Quality (AHRQ). Five Major Steps to Intervention (The “5A’s”).U.S. Public Health Service, Agency for Healthcare Research and Quality. Rockville, MD. Accessed July 21, 2011 from http://www.ahrq.gov/clinic/ tobacco/5steps.htm Cox Communications in partnership with the National Center for Missing & Exploited Chidren (NCMEC) and John Wals. (2007). Teen internet safety survey Wave II: Research findings. Accessed April 28, 2012 from http://ww2.cox.com/wcm/en/ aboutus/datasheet/takecharge/archives/2007-teen-survey. pdf?campcode=takecharge-archive-link_2007-survey_0511 Cox Communications. (2009). Teen online and wireless survey: Cyberbullying, sexting and parental controls: Research findings. Accessed Aug. 18, 2011 from http://www.cox.com/takecahge/ safe_teens2009/media/2009.teens survey internet and wireless. pdf

Genachowski, J. (2009). Statement to the United States Senate Committee on Commerce, Science and Transportation. Rethinking the Children’s Television Act for Digital Media Age. Hearing, July 22, 2009. Accessed Aug. 15, 2011 from http//www.gpo.gov/ congrss/senate/senate07chll.htm. Lenhart, A. (2012). Teens, smartphones & texting. Pew Research Centers. Washington, D.C. Lenhart, A., Ling, R., Campbell, S., & Purcell, K. (2010). Teens and mobile phones. Accessed August 5, 2011 from http//pewinternet.org/Reports/2010/Teens-and-Mobile Phones. aspx. National Center for Missing & Exploited Children. Laws concerning child pornography. Accessed Aug. 18, 2011 from http://www. missingkids.com/missingkids/servlet/PageServletLanguageCou National Conference of State Legislatures. 2010 legislation related to sexting. Accessed Aug. 18, 2011 from http://www.ncsl.org/default. aspx/tabid=19696 O’Keefe, G.S., Clarke-Pearson, K., and Council on Communications and Media. (2011). The impact of social media on children, adolescents, and families. Pediatrics, 127(4), 800-804. Reed, N., & Robins, R. (2008). The effect of text messaging on driver behavior: A simulation study. Publish Project Report PPR 367. Transportation Research Laboratory. Stoutt, M. (May 5, 2011). “Boys in Bridgewater school bullying video suspended. Enterprise.new.com, Accessed Oct. 1, 2011 from http//www.enterprisenews.come/answerbook/bridgewaters/ x1078554162/Bridgewaters. United States v Broxmeyer, (2nd Cir. 2010). Accessed Aug. 15, 2011 from http://federal-circuits.vlex.com/vid/ United-States-v-broxmeyer-215215855. Webb, C. (2009). Sexting. The University of Texas Health Science Center at Houston-Health Leader, Accessed Aug. 15, 2011 from http//www.uhealthleader.org/archive/children/teen/2009/ sexting/.0514htm Weiss, R., & Camenow, D. (2010). Smart phones, social networking, sexting & problematic sexual behavior: A call for research. Sexual Addictions and Compulsivity, 17(4), 241-246. Ybarra, M.L. (2004). Linkage between depression symptomatology and Internet harassment among young regular Internet users. Cyber-Psychology & Behavior, 7(2), 247-250. Ybarra, M.L., Alexander, C. & Mitchell, K.J. (2005). Depressive symptomatology, youth Internet use and online interactions: A national survey. Journal of Adolescent Health, 36(1), 9-18.

NBNA.org — 21 Halting the Tide of Childhood Obesity in Chicago’s School District 88 Daisy Harmon-Allen, RN,PhD

T

he Nation’s childhood obesity rate has more than tripled over the past 30 years. The Chicago Chapter National Black Nurses Association (CCNBNA) in partnership with Monroe Baptist Church has launched an obesity prevention effort in the Bellwood Illinois School District 88 called, “Halting the Tide of Obesity in SD88.” This effort was supported by a $1000 mini-grant from NBNA. The project is directed at four elementary schools in the Village of Bellwood. CCNBNA has recruited four school nurses in the schoold district to identify obese or overweight students using the Early Periodic Screening, Diagnosis, and Treatment (EPSDT), the child health component of Medicaid, physical exam forms to serve as a baseline metric. Our goal will be to reduce obesity by 5% by June 2014 using a combination of diet and exercise. The body mass index (BMI) is calculated based on the data recorded from the EPSDT—38.6% of the children were identified as overweight or obese. Sandra Jones, SN, recently observed how large the third grade children in the school district were for their chronological age. Some of the children were barely able to fit at their desks and had to sit at a table because of their body size. Some children struggle to perform even simple tasks such as walking up and down stairs and off the bus. They often have to stop to catch their breath. These children are often teased by other children.

The CCNBNA also conducted a healthy living demonstration for 29 community participants at the Monroe Baptist Church. The project team taught the participants the importance of a healthy diet. They also prepared a low calorie snack/ salad comprised of vegetables, spinach and baked chicken, along with a beverage of water with lemon. The Obesity project was a great success—there was an all-girl race and a bicycle raffle. Lastly, the superintendant, staff, parents, and students became aware of the extent of the obesity problem within the community. Watch our Obesity project video: https://www.dropbox.com/s/40oy9cp414xl4hb/Halting%20 the%20Tide%20of%20Obesity%20in%20SD%2088%20 Video.mp4 Dr. Allen is the President of the Chicago Chapter National Black Nurses Association and the President of School Board 88 Bellwood, Illinois. Her motto is “count not the blessing you have received but, the blessing you have shared.”

22 — NBNA.org Save a Life: A New Cardiovascular Innovation Gayle R. Disu-Cummings, BSN, RN Member, Chicago Chapter NBNA

A

pproximately, 300,000 people in the U.S. go into cardiac arrest every year and about 90 percent of those die according to the Center for Disease Control and Prevention. The American Heart Association (AHA) says immediately starting CPR when a person goes into cardiac arrest-when the heart stops beating-can double or triple that person’s chances of survival. The purpose of this article is to present the NBNA nursing community of the need to teach lay people bystander CPR. Bystander CPR is a new concept introduced in 2010 by the AHA. According to Sutton et al. (2011), cardiac arrest is a major public health problem affecting thousands of individuals each year in both the hospital and before hospital settings. The scope of the problem is large, the quality of care provided during resuscitation attempts frequently does not meet quality of care standards despite evidence-based cardiopulmonary resuscitation (CPR) guidelines, extensive provider training, and provider credentialing in resuscitation medicine (p.1). The goal of instruction is to re-educate nurses, lay people and the community-at-large. Cardiac arrest, also known as sudden cardiac death, is unpredictably occurring at places other than medical institutions (Lee, 2012 p. 401). In 2010, the AHA guidelines shifted priorities during cardiac arrest from early airway breathing management toward providing high quality uninterrupted chest compressions and early defibrillation for shockable rhythms, which is exemplified in the acronym change from Airway-Breathing Circulation, or ABC, to Circulation-Airway-Breathing or CAB. The catchphrase “Push hard, Push fast” with minimal interruptions and prompt defibrillation may be the most important action during cardiac arrest that will translate into survivor benefit (Sutton, et al., 2011). Recently one of the CCNBNA members was at a social event. The DJ played a line dance song called the “Wobble.” A guest was vigorously doing the dance. At completion of the dance, she walked back to her chair and fell to the floor. The CCNBNA responded having witnessed a Sudden Cardiac Arrest she immediately had someone call 911 and she started administering chest compressions. In By-Stander CPR you no longer look for a pulse wasting valuable time. She was certified in bystander CPR and she was able to administer rapid and deep chest compressions and sustain the victim until the paramedics arrived. They intubated the victim and took her to the hospital. In Chicago all paramedics are encouraged to take all cardiac arrest victims to the nearest Cardiac Hospital. In this scenario the nearest Cardiac Hospital was 10 minutes away.

Later I found out the victim was a registered nurse. Two of her daughters were cardiac specialists. When they arrived at the hospital the ER team was ready to call the code. The daughters requested the code be continued and the victim be given ice saline with the administration of a hypothermia unit. This was done and the patient was sent to the Cardiac Care Unit. This treatment is risky, you cannot predict the level of brain death for several days. This story has a happy ending. After being in intensive care for seven days our nursing colleague responded, she was alert with only minimal memory loss, she completed cardiac rehab, and now she is back performing her favorite line dance “The Wobble”. In gratitude she has become a member of CCNBNA and NBNA Remember, the goal of the American Heart Association (AHA) is to train more lay people to perform bystander CPR, and to make sure that those who are trained do not hesitate to act promptly. In the mean time, view the AHA video “Hands Only CPR” online. References: Lee, K. (2012). Cardiopulmonary Resuscitation: New Concept, Tuberculosis and Respiratory Diseases, 72(5) p. 401-408 doi. org/10.4046/trd.2012.725.401 Sutton, R.M. NadKami, V. & Abella, B.S. (2011). Putting it all together to improve resuscitation quality. Journal of Emergency Medicine Clinics of North America. 30(1): p. 105-122.doi.10.1016/ jemc.2011.09.001

NBNA.org — 23 A Possible Explanation for African Americans’ Poor Type 2 Diabetes Outcomes Donna Calvin, PhD, FNP-BC

T

he complications of type 2 diabetes in most cases are preventable. However, African Americans are disproportionately affected by type 2 diabetes and its devastating complications. African Americans when compared to Whites are 1.5 times more likely to develop blindness, 2.7 times more likely to have a lower extremity amputation and approximately 4 times more likely to have kidney failure requiring dialysis or a transplant. This disparity still exists even when they have the same social and economic status as their White counterparts. Researchers suggest that the more one believes they can get complications from diabetes, the more they will do the things under their control to prevent complications. Therefore, we surveyed a select group of African Americans to see if they believed they were at risk for ever developing complications of type 2 diabetes, since this may be one of the reasons for their poor diabetes outcomes. We surveyed 143 African American adults from three local public health facilities in Chicago. All were diagnosed with type 2 diabetes for less than 5 years and stated that they did not have any diabetes complications. What we found The majority reported knowing they had high blood pressure prior to taking the survey. Even though their A1C and blood pressure readings were high most of the people surveyed did not see themselves as being at risk for diabetes complications. n A1C is a measure of how well your diabetes has been controlled over the past 90 days. n High blood pressure increases the risk of having complications from diabetes. African Americans with type 2 diabetes are at greater risk than others for blindness, kidney failure and lower extremity amputation, especially if they have hypertension. However, the people surveyed believed that there was only a slight risk of having these complications and rated them as the least likely of all the diabetes complications they may develop. Conclusions It is necessary to heighten awareness of the seriousness of type 2 diabetes. Many of the people surveyed did not have good control of their diabetes and blood pressure which puts them at high risk for developing diabetes complications. There is a possibility that good self-management skills are not consistently practiced because they see themselves at lower risk for complications.

Recommendations for healthcare providers to improve diabetes outcomes The patient’s perceptions of the disease and their socioeconomic status should be considered when developing the management plan. Dialogue with patients should be ongoing and done with a non-accusatory affirming manner. In other words don’t blame the victim!! Healthcare providers should discuss the seriousness of type 2 diabetes and evidence based strategies to prevent complications with each encounter. Diabetes complications are preventable. The following self-management skills will help: n Monitor your blood sugars and blood pressures n Keep a record of the results to share with your doctor n Request a copy of all your lab results and discuss them with your doctor. n Keep a food diary Further research is needed to understand how people assess their risk for diabetes complications. The information is a brief summary of findings from a published research article: Calvin, D., Quinn, L., Dancy, B., Park, C., Fleming, S., Smith, E., Fogelfeld, L. (2011) African Americans’ Perception of Risk for diabetes complications. Diabetes Educator, 37(5)689-698 This research was funded by a CNNT Research Grant (National Kidney Foundation) and Reducing Health Disparities in Underserved Populations (NIH T32 #NR007964).

Dr. Donna Calvin is a Post-Doctoral Research Associate in the College of Nursing whose research focus is preventing diabetes complications, specifically end stage renal disease (kidney failure). Dr. Calvin is a member of the Chicago Chapter NBNA. She is a family nurse practitioner and certified nephrology nurse. She was instrumental in developing and managing a chronic kidney disease clinic on the south side of Chicago for the sole purpose of preventing the progression of chronic kidney disease. Dr. Calvin is currently conducting qualitative research focused on identifying protective and risk factors that impact the progression of chronic kidney disease among African Americans with type 2 diabetes. Her long term goal is to develop medical homes for chronic kidney disease patients that are managed by nurses and nurse practitioners.

24 — NBNA.org Emotional Maturity and Its Direct Correlation to Health Promotion and Illness Prevention Gessie E. Belizaire, MA

Administrative Assistant, NBNA

T

he lives of many Americans, within this past decade alone, have experienced an assortment of changes at an exponential rate. The changes are evident, from global warming, to this nation’s economic climate, to the health care system. Americans have found themselves forced to adapt and to be resilient to so much. Now more than ever, people are finding that more is being required of them both at home and at work. The demands on one’s life have become so aggressive that often times it spills over to their physical and/or mental well-being. How does one, in the face of all these changes, handle the ups and downs of life without compromising his or her health? Dr. Martha Stark, a Boston-area Psychiatrist, Harvard Medical School faculty member, and author of Modes of Therapeutic Action, calls on psychological or what others or calling emotional maturity as the solution to dealing with life’s ups and downs. Stark defines emotional maturity in Elaine Gottleib‘s article titled Emotional Maturity: Personal Strength as, “being able to accept the reality of people and things as they are, without needing them to be other than that.” To be able to be at peace with the things like global warming that cannot be controlled or changed and to also change the things which can and should be changed is true maturity. (Gottleib, 2013). True maturity is not something that people in general can arrive to overnight. Maturity is a process that is first learned at home that later grows and continues to do so through life experiences. In Gottleib’s article she lists a collection of healthy character traits that she discovers all mature people possess. Those character traits are: n Ability to know what you want and the capacity to make it happen n Self-Control and thinking before you act n Self-reliance and the ability to take responsibility for your life and actions n Patience n The ability to sustain intimate relationships and establish positive connections with others n Generosity and the desire to give and be there for others n Integrity n A sense of balance and equanimity in dealing with stress n Perseverance n Decisiveness n Humility and the ability to admit when you are wrong Mature people have mastered the work/life balance so well that it can even be done all while smiling.

Nikki Gloudeman’s (2013) article, “Bad Attitude Blues Turn that Sad-Face Emotion: (downside-up),” supports through illustration this article’s claim that Emotional Maturity is a way to promote and to put to good practice health prevention. Gloudeman surveys the day in the life of a meeting planner for all that it encompasses both good and bad. Many times the bad that comes with the profession can overtake even the positive of people with its exhausting demands and often defeated work. She goes on to explain the seven steps in which people can put to practice to beat those bad attitude blues. The seven steps also help to support Gottlieb’s claim regarding the healthy character traits that emotionally mature people tend to possess for the reason that the steps help people to maintain a sense of balance and equanimity in dealing with the stressors of high stress professions like meeting planning. Studies have shown in Gloudeman’s first step that ‘chillingout,’ whether through meditation or listening to music, has been proven to significantly reduce blood pressure, boost your immune system, ease pain, help with depression and anxiety, and curb diabetes and high cholesterol. Second on the list is moving the body via exercise. Gloudeman reports that according to the Mayo clinic, “even a short dose of exercise noticeably boosts energy levels and stimulates brain cells, leaving you feeling happier and more relaxed… exercise also promotes deeper, sounder sleep.” Third, laugh and cry daily. A good belly laugh will cause blood pressure to come down, circulation to go up, muscles to relax, and enthusiasm to increase greatly. Laughter has also been known according to the Mayo Clinic to add a boost to the immune system and to stimulate both the heart and lungs. Fourth on the list is, eating right. To sustain happiness, well-being, and health it is recommended that healthier options in diet are best to be used. Even in a fast paced hotel setting of meeting planning there are alternative options available that are both nutritious and healthy. Fifth, Gloudeman sites sleep; The Mayo Clinic recommends seven to nine hours of sleep a night. It is critically important to the health and happiness of all to get adequate sleep. People, who are sleep deprived, tend to be more susceptible to weight gain, feel pain, contract colds/flus and suffer fluctuating heart rates, breathing rates, and blood pressure. Sixth on the list is love. Those who embrace loving relationships and are able to open themselves up tend to live healthier and longer lives. Going back to Gottlieb’s article this type or group of people are conveying a healthy emotionally mature character trait by having the ability through the power of love to sustain intimate relationships and to maintain positive connections with others. Last

CONTINUED ON PAGE 26

NBNA.org — 25 Gender Differences in Post-Traumatic Stress Disorder: A Case Study Kathryn Peoples, LTC (Retired, USAR)

“W

hy is my Post-Traumatic Stress Disorder (PTSD), not like your PTSD?” said Alice to the Mad Hatter. He replied, “It’s because you’re a girl.” Not unlike Alice, the experiences and coping strategies of women in the military with post-traumatic stress disorder are considerably different than those of males. We are told that women do not serve in combat. That might be true, but they serve in combat service support units which are adjacent to, if not on the battlefield. The Society for Women’s Health Research held a research conference in 2011 entitled “What a Difference an X Makes”1 emphasizing the gender differences of veterans’ health especially in the areas of PTSD and depression. According to Moseley-Brown, (2011) the conference keynote speaker, there are 23 million veterans of which women account for 1.8 million1,2. This is triple the number of female veterans after the Viet Nam war2. This increase in female veterans, coupled with an increase in male veterans puts a significant strain on the Veteran Administration (VA) Health System not only in terms of numbers but a medical system that is ill equipped to handle large volumes of female with unique issues. Feczer & Bjorkland (2009) 3 and Benda & House (2003)4 describe gender bias in the diagnosis of PTSD. They examined whether psychiatrists and psychologists would be less likely to diagnose PTSD in women versus male veterans. Benda and Holly (2003)4 note that posttraumatic stress disorder in males is almost twice the prevalence of females. They determined that men experienced more trauma related to war, whereas women experienced trauma more related to exploitation. Exploitation related to the work environment and rank structure, sexual trauma and the need to prove themselves capable in a male dominated milieu just to name a few. While working as the chief medical provider for Company C, Wounded Warrior Transition, Fort Carson, CO, there was a female who was denied compensation based on PTSD but was awarded a much lesser compensation based on the diagnosis of adjustment reaction. This rating was constructed in part due to her documented alcoholism. This soldier, let’s call her Alice, pre-deployment was a very outgoing African-American divorcee, non-drinker, devout Christian, age 42, with two teenage children she left in the care of her 76 year old mother while she was deployed and a 22-year-old son who was in the Air Force Reserves. Her military job was that of a truck driver. In the first four months of her 12-month deployment her convoy was attacked three times.

During attack number two, her co-driver (26 years old) was mortally wounded and died in her arms. According to her First Sergeant5 her behavior changed dramatically and she began drinking alcohol (personal communication). Post-deployment, Alice lost her civilian job for non-attendance and drinking on the job. Her mother and children so not recognize her as the daughter and mother she once was. She no longer attends church or any other social gatherings, preferring to isolate herself from others. She cries. She is unable to sleep without drinking. She startles easily and is still unable to ride in a moving vehicle without experiencing extreme stress and anxiety. She attempted suicide four months after returning home. This is when her First Sergeant5 made provisions for Alice to be admitted to the Warrior Treatment Unit for care. The definition of PTSD according to the DSM-IV (2004) 6 is “exposure to a traumatic event or experience involving intense fear, horror, or helplessness. The event or experience must involve a threat of death, serious injury, or physical integrity.” Alice exhibited symptoms of PTSD which included repeated thoughts of the traumatic event, lasting longer than a month, isolative behavior and numbing herself with alcohol. She tries to avoid stimuli associated with the event by not riding in moving vehicles. Wallace and Young, (2009)7 cite the frequent use of alcohol and other mind altering substances as an anesthetic used by individuals who wish to numb themselves from psychic pain. Just as we don’t know the impact of Alice’s mental status after her return from Wonderland – neither do we know the durational impact of deployment anxiety for female veterans? What is known for sure is that social supports are most important for all women. The deployed female veteran is cut off from her main support systems (eg.) friends and family. Her usual methods of coping are not available to her or We know that most female veterans medical needs will be treated in the private sector where knowledge of the military culture is minimal. It is imperative that we incorporate into our history whether or not our female patient is a veteran, whether she has been deployed and whether she has experienced physical, mental or sexual stress while in the military. Fitzgerald (2010) 8 states that this assessment must be asked each time the veteran is seen as PTSD and other emotional disorders may manifest years later. Until prevention and best practices methods are developed for female veterans impacted by PTSD, disparities will go unnoticed and unresolved.

CONTINUED ON PAGE 26

26 — NBNA.org Emotional Maturity... contined from page 24 on the list is letting go. Gloudeman speaks to the profession of meeting planning to drive home that no matter how much planning that goes into an event the uncontrollable will always happen. It is important to be aware of that and to let go of the things that cannot be controlled and focus on the things that are within one’s control. For instance, being a working parent is something that many are doing and controlling, however, many struggle with being fulfilled at both work and home. Lisa Plummer (2013) addresses in her article, “The Work Life Balance” the struggle to be fulfilled at both work and home that many Americans face. Plummer uses the fast paced industry found in tourism and events to illustrate just how possible it is to balance and be fulfilled at both work and home. To support Plummer’s claim she highlights the lives of many successful men and women who are also parents and asks them to advice others on what brings them balance and success at both work and home. All made reference to the following: set boundaries, learn to say no, take advantage or take part in changing the culture. For instance, take five minutes out of your travel meeting to call your family, and lastly, keep work-life in progress. To realize the remained importance of finding time to exercise, socialize, vacation, and for career development will help to attain life-equilibrium. Research by Plummer, Gloudeman, and Gottlieb help to support just how much personal strength there is in being emotionally mature. Not only are there individual health benefits to being emotionally mature but studies have also shown and are continuing to show that entire professions are also benefiting. In a clinical article recap written by Elisa Becze (2013) titled, “Five-Minute in Service Increase Emotional Intelligence Awareness during Clinical Rounds” emotional intelligence was discovered to have direct correlations with reduced burnout and improved staff retention, team performance and communication, safety and customer satisfaction. In the January 2013 issue of the oncology nursing forum a pilot study was conducted by Codier, Freitas, and Muneno using emotional intelligence awareness and activities as the novel approach to bettering nurses’ work environment and quality patient care. For five minutes as part of either staff or charge nurse’s rounds, during a 10 month period, were asked to rate their and their patients emotional state for that day. The nurses found at the end of the pilot that the intervention found in the study were quite helpful to some degree. In summary, emotional maturity has for the meeting planner, the working parents of the world, and oncology nurses been beneficial in various aspects. The common benefits all point to health promotion and health prevention, all of which, could not be attained, had some if not all of Gottlieb’s healthy character traits not been applied to the lives of the people that were assessed in this article. In this changing world, having emotional maturity helps people to live better, longer, happier, more resilient, and healthier lives.

References Becze, E. (2013, June). Increase emotional intelligence awareness during clinical rounds. ONS Connect, 36-37. Gloudeman, N. (2013, March). Bad attitude blues turn that sad face emoticon: (down side-up :). Smartmeeting the Intelligent Way to Plan, 73-76. Gottlieb, E. (2013). Emotional maturity: your personal strength. Beliefnet. Retrieved October 1, 2013, from http://www.beliefet. com/healthandhealing/getcontent.aspx?cid=14207 Plummer, P. (2012, November/December). The worklife balance. Connect Meeting Intelligence, 57-61.

PTSD... contined from page 25 References 1. Moseley-Brown, B, Keynote Speaker. (2011). What a difference an X makes. The State of Women’s Health Research: A Focus on Female Veterans 2. U.S .Department of Veterans Affairs. Center for women’s veterans fact sheet, 2010. Available at www.va.gov/WOMENVET/Final_ CWV_Fact_Sheet_October2010.pdf AccessedOctober21,.2013. 3. Feczer, D & Bjorkland, P. (2009). Forever changed: Posttraumatic stress disorder in female military veterans. A case report. Perspectives in Psychiatric Care 45(4): 278-291. 4. Benda,BB & House,HA. Does PTSD Differ According to Gender among Military Veterans? Journal of Family Social Work, (2003). 7(1):15-34 5. (2009) Personal Communication, Wounded Transitional Warrior Unit. 6. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.) Washington, DC: Author. 7. Wallace, AE, Sheehan, EP, and Young, Y. Women, Alcohol, and the Military: Cultural Changes and Reductions in Later Alcohol Problems among Female Veterans, Journal of Women’s Health 2009;18:1347-1353. 8. Fitzgerald, CE. Practitioners Improving nurse practitioner assessment of woman veterans, Journal of the American Academy of Nurse Practitioners 2010;22: 339-345.

NBNA.org — 27 The Role of the Church on HIV/AIDS in the African American Community

A

ccording to the Centers for Disease Control (CDC) and Prevention; Blacks continue to experience the most severe burden of HIV when compared with other races and ethnicities (CDC, 2013). Blacks represent approximately 12% of the U.S. population, but accounted for an estimated 44% of new HIV infections in 2010. Blacks also accounted for 44% of people living with HIV infection in 2009. Since the epidemic began, more than 260,800 blacks with an AIDS diagnosis have died, including an estimated 7,678 in 2010. An estimated 1 in 16 black men and 1 in 32 black women will be diagnosed with HIV infection unless the course of the epidemic changed (CDC). The statistics show that there are significant opportunities for education, program development, community engagement, and other initiatives in the black community. Where do we start? How do we get the word out? What role does the black church play with impacting the epidemic of HIV/AIDS in the community? Has the church failed the black community? There is no evidence to support that the church has failed the black community but statistics show that opportunities exist. This article provides documentation to show that although the black church is working to address the HIV/AIDS epidemic, there is still much to do. The Westside Gazette wrote, “The black church continues to play a role in shaping the community around it and how it is actively seeking to improve urban communities and provide safety for black children” (Henry, 2013). One question that may be asked is whether or not the rise of HIV in the black community falls under the heading, “Improvement to Urban Communities” or does it fall under, “Provide safety for black children?” One may presume that the black church is not doing enough to deal with the devastating effects of HIV/AIDS, but there are a number of churches that take the lead in this arena. The black church is, however, encouraged take actions to the community by developing strategies to curb the effects of HIV/AIDS thereby helping to improve urban communities and provide safety for black children (Henry, 2013). Trinity United Church of Christ, in Chicago, IL, is a good example of the church taken action against HIV/AIDS. Trinity has an HIV/AIDS Support Ministry. Dr. Jeremiah Wright started the ministry in 1993 as a response to the treatment of the son of one of the deacons at the church. What started as a support group for its members, with an initial ministry membership of less than 100, quickly grew. The HIV/AIDS Support Ministry provides support, both group and individual, by professional counselors in a confidential and safe environment, community outreach and education, weekly and quarterly spirituality group sessions for both men and women. The sessions are conducted by pastoral staff, nourishment and fellowship after each session are provided, case management services, primary care, mental health, substance abuse counseling and prevention education are rendered. Simon (2013) stated that the church focuses on the community, going out to educate and support any and every one” (Simon, 2013). Other ministries such as Enon Tabernacle Baptist Church in Philadelphia, and Beulah

Jason Russell, BS

United Health Scholar

retrieved from http://www.cdc.gov/hiv/risk/racialethnic/aa/facts/index.html

retrieved from http://www.cdc.gov/nchhstp/newsroom/docs/2012/HIV-Infections-2007-2010.pdf

Missionary Baptist Church, in Atlanta are also involved in the effort to improve health conditions related to HIV/AIDS in the community. There are several organizations that the church can turn to for help and identify ways to combat HIV/AIDS. Balm in Gilead, Inc., The Association of Nurses in Aids Care (ANAC) and the Whitman Walker Clinic (WWC) in Washington, DC are three organizations working in the community. Balm in Gilead is a not-for-profit organization that specializes in the unique needs of African Americans and African American congregations for health education and disease prevention. Balm in Gilead teaches the church how to design programs that best work for the ministry, community, and how to mobilize efforts. ANAC and WWC in Washington, DC are organizations that offer services that help the underprivileged receive treatment and help to prevent HIV from being transmitted. ANAC and WWC are working with the National Institutes of Health to determine the best ways to offer pre-exposure prophylaxis in the community. The black church can play a significant role by initiating the dialog with congregations about advances in health care for

CONTINUED ON PAGE 28

28 — NBNA.org HIV/AIDS. Ministries should know that there are ways to pay for treatment through the organization’s like WWC. The National Association for the Advancement of Colored People (NAACP) has HIV as part of the organization’s platform. NAACP has fought to combat policies and practices that undermine human rights and social justice for many reasons. One reasons is because of the fact that Blacks are more likely to become infected, less likely to know they have the disease and more likely to die from HIV/AIDS than any other race (NAACP, 2013). NAACP conducted a year-long, 11-city research tour with over 250 faith leaders across denominations to identify best practices and challenges when addressing HIV within the Black Church based on that knowledge. With this collected research and insight from the HIV manual advisory committee, we developed The Black Church and HIV: The Social Justice Imperative. NAACP Health Department has written the Pastoral Brief and Activity Manual (PBAM) to encourage faith leaders to engage in HIV advocacy. These tools were created to educate, alleviate concerns and motivate faith leaders to action (NAACP, 2013). PBAM helps to identify simple ways the Black church can address the HIV epidemic that is disproportionately impacting the Black community. PBAM is used to inspire the community served to join the effort as advocates and agents of God’s love to support those infected and affected by HIV. Efforts include feedback from pastors who participated in the 11-city research tour hosted by NAACP and shared thoughts and experiences from leaders that participated on the tour. The HIV/AIDS epidemic hit home in Washington, DC. Boorstein (2013) documents that the percentage of Washingtonians living with HIV or AIDS is among the highest of any U.S. city – 2.7 percent. The rate is much higher, 4.3%, among African Americans, for whom life often revolves closely around the church. Since the epidemic began in the early 1980s, many health leaders have criticized black clergy for staying silent as the virus has spread because of the church’s condemnation of gay sex and drug use. Others say the black church has been unfairly singled out. On the eve of the 19th International AIDS Conference to be held in the Washington, DC, Boorstein (2013) asked several local pastors and other experts to discuss the black church’s handling of HIV/AIDS. The Rev. Anthony Evans, President of the D.C.-based National Black Church Initiative (NBCI), a network of 34,000 U.S. churches, provided his perspective and insight into the issue. According to Boorstein, Evans stated, “The black church let the 1980s pass us by” in dealing with HIV/AIDS but has awakened. In 2010, NBCI declared a national health emergency in the black church and unveil a controversial recommendation for pastors to disseminate: “We want everyone to take a year off of sex and deal with who they are.” Evans said, “Parishioners should use the year of celibacy to focus on their sexuality and relationships with friends, family and God.” He wanted people to get tested and confront the results. “If you are positive, let your partner know. If you can’t, let your pastor or friends know. Someone has to know who you really are. You can’t be a mystery anymore. AIDS has uncovered the mysteries of who we are.” Preachers, such as Rev. Timothy Sloan of St. Luke Missionary Baptist Church in Humble, TX, take a stance on the HIV/ AIDS condition of the black community. Pastor Sloan infuses his lesson of the day with a topic once considered taboo if

photo from http://thegrio.com/2013/09/24/ from-the-pulpit-to-the-pew-hivaids-and-the-black-church/

not completely off limits among black congregations (Brock, 2013). Brock explained that the message of awareness rang throughout the walls of the church at a recent service as part of a larger effort to address a challenge that Sloan and a growing number of pastors are aligning with the NAACP to deal with the challenges the HIV/AIDS epidemic and its impact on the black community. Brock (2013) explains that since the beginning, AfricanAmerican churches have served as epicenters of their communities and as a loud voice on social justice issues, ranging from poverty to discrimination. The same black church that ushered in the historic victories of the Civil Rights era will stand once again at the forefront of this important social justice issue (Brock). Despite the CDCs findings that the number of new HIV/AIDS infections among blacks is nearly 8 times the rate of whites and double that of Latinos, churches have historically avoided any debate on the disease in an effort to thwart uncomfortable topics such as HIV/AIDS. Pastor Sloan, along with dozens of pastors across the country, understands that to truly stop this crisis, the church must serve as a reliable partner in the fight to end HIV/AIDS. References Boorstein, M. (2012). Wither the black church on HIV/ AIDS? Retrieved December 1, 2013, from http:// articles.washingtonpost.com/2012-07-20/ local/35488280_1_black-church-black-clergy-hiv-or-aids Brock, R. (2013). From the pulpit to the pew: HIV/ AIDS and the black church. Retrieved December 1, 2013, from http://thegrio.com/2013/09/24/ from-the-pulpit-to-the-pew-hivaids-and-the-black-church/ Centers for Disease Control and Prevention. (2013). HIV in the United States: At a glance. Retrieved October 29, 2013, from http://www. cdc.gov/hiv/pdf/statistics_basics_factsheet.pdf Henry, C. (2013). The role of the black church in the civil rights movement. Retrieved October 29, 2013, from http://thewestsidegazette. com/the-role-of-the-black-church-in-the-civilrights-movement/ National Association for the Advancement of Colored People (NAACP). (2013). The black church and HIV: The social justice imperative. Retrieved December 1, 2013, from http://www. theblackchurchandhiv.org/pages/about-the-initiative Simon, M. D. (2011). Why the black church must get real about HIV/AIDS. Retrieved October 29, 2013, from http://thegrio. com/2011/08/16/churches-must-get-real-on-hivaids/

NBNA.org — 29 BBNA - Mentorship in Action! Jennifer J. Coleman, PhD, RN, CNE

President, Birmingham Black Nurses Association

T

wenty-two members of the Birmingham Black Nurses Association (BBNA) attended the NBNA 41st Annual Institute & Conference in New Orleans. Included among our attendees were several participants from our chapter’s mentorship program. BBNA sponsored the attendance of two current nursing students and two of our recent graduates. We are so proud of our students and new nurses and the professional manner in which they represented themselves and BBNA at the national conference. Anyone who encountered BBNA members in New Orleans probably noticed the huge smiles on all of our faces. We were unable to stop smiling and cheering as our mentees met and interacted with nurses, students, and nurse leaders from all over the United States. Our chapter mentorship program provides ongoing support, guidance, and encouragement with scheduled monthly meetings in addition to informal mentor-mentee activities. Nursing student retention, graduation, and professional role development are important goals. Program activities include sessions on study skills, time management, test taking strategies, professional communication, image development, career planning, etc. We offer professional development via role modeling, socialization, community outreach activities, and discussions related to our individual responsibilities in making a positive difference in minority health outcomes. For the past three years BBNA’s mentorship program has sponsored NBNA conference attendance for mentees to participate firsthand in national networking and collaboration with nursing professionals. This year two nursing students and two new graduate nurses accompanied BBNA mentors and chapter members to New Orleans. We began preparing our students during our September 2012 mentorship meeting. We discussed professional abstract preparation and challenged our nursing students to consider presenting at the 2013 NBNA conference. Four students accepted the challenge and were successful in having their abstracts accepted for presentation in New Orleans. Each student prepared her presentation and BBNA mentors assisted with editing and format. Personal support and professional guidance were included in conference preparations as chapter members offered advice to students on proper attire and behaviors. We also suggested bringing a family member for emotional support if needed. The week before the conference, BBNA’s Membership Chair reserved a conference room and several chapter members met with the students to rehearse their presentations. We discussed probable room size and configuration, estimated number of attendees, format for conference workshops/institutes, and professional presentation attire. As BBNA president, I speak for our entire chapter when I say how excited we were to witness the professional skills and confidence exhibited by our student members. We are honored to be a part of their present and future successes. Their NBNA conference presentations were outstanding. Isis Johnson, nursing student at Jefferson State Community College Nursing

Education Program, and Juanita Jones, nursing student at the University of Alabama at Birmingham School of Nursing, presented Nursing Students’ Clinical Success Strategies during the Nursing Education Workshop on Saturday. Two of our mentees, Ashley Wagner and Trinity Henderson, are May 2013 BSN graduates and were recently successful on NCLEX-RN. Ashley Wagner presented Nursing Care During Iron Chelating Therapy in Children with Sickle Cell Disease during the Children’s Health Institute on Friday. Trinity Henderson presented Emergency Medication Use in Schools during the Emergency Medicine Workshop on Saturday afternoon. BBNA chapter members planned our strategy so that several of us were in attendance at each of our mentees’ presentations in order to offer moral support and encouragement. In fact, our two nursing students expressed public appreciation by introducing their mentor at the end of their presentation. I am so proud of each of our mentees. Their first national conference attendance was a huge success! The fact that they were also podium presenters is an added bonus and an indicator of the quality nurses they are sure to become. BBNA members believe that ongoing support and professional development of prospective minority nurses is critical. We believe that our nursing students are well qualified to provide meaningful, patient-centered care that will bridge the health disparities gap among ethnic minorities. Let’s all raise the bar for our nursing students! Set high standards for our future nurses! BBNA proudly experienced the high level of expertise and professionalism of our student members as they met and surpassed our expectations! Dr. Jennifer J. Coleman is an Associate Professor, Ida V. Moffett School of Nursing at Samford University in Birmingham, Alabama. She holds a PhD in Nursing Ethics from the University of Southern Mississippi in Hattiesburg, a MSN in Nursing Education from Samford University, and a BSN from the University of Alabama in Birmingham. She also holds certification from the National League for Nursing as a Certified Nurse Educator. She is president of the Birmingham Black Nurses Association and Mentorship Program Coordinator.

30 — NBNA.org Forward Mentoring A Professional Investment

Reflections of Student Harpreet Singh-Gill, RN United Health Scholar Member of the Milwaukee Black Nurses Association

Sana Savage

M

entoring embodies an interpersonal guiding relationship between an experience individual and a less experience person (Mentor/protégé/protégée/mentee). It can be peer to peer, senior to junior, or expert to novice. There are a plethora of literature in mentoring and characteristics of mentoring. However, few if any has addressed forward mentoring. The concept of forward mentoring is not new. When we successfully mentor someone and that person is grateful and you response by asking them to pass it on and help someone else likewise or greater, we are essentially asking the individual and setting the stage for forward mentoring. “When you’ve worked hard and done well, and walked through that doorway of opportunity…you do not slam it shut behind you… you reach back, and you give other folks the same chances that helped you succeed” First Lady Michelle Obama. This quote from the First Lady Michelle Obama captures the essence of forward mentoring. Forward mentoring increases the chances of individuals that are driven to succeed. It uplifts, enlightens, and encourages one to soar and succeed. The mentor who forward mentors enables the protégé to jump barriers. This is particularly necessary in the nursing in order to move the profession forward in a positive direction worldwide. Being short sighted and not wanting to share what one has worked hard for is a basic human tendency. However it is only through sharing of such knowledge and skills that we as a whole could move forward to bigger and better accomplishments, products, goods and services. Forward mentoring is a great return on investment. It is the gift that keeps giving. It serves as an entrance/platform to learn, grow, achieve, and succeed and an exit to serve and perhaps create something bigger, and making a difference. The many positive characteristics of mentoring lend themselves to forward mentoring. These include but not limited to being a selfless facilitator, knowledgeable, motivational, honest, respectful, stewardship, effective verbal and nonverbal communicator, resourceful networking, open-minded, good listener, accessible and available, a team player, and a character builder. Forward mentoring should be a professional obligation in order to foster growth and knowledge for future successors. Do not miss an opportunity to forward mentor and impact the next generation of leaders. Forward mentoring is beneficial in a myriad of ways, as new perspectives are unfold both for the protégé and the mentor. Forward mentoring is an investment toward optimal personal, professional, and organizational outcomes. Nurses must engage in forward mentoring to once and for all nullify the perception that “nurses eat their young.”

I

began to reflect upon my journey as a biracial student throughout nursing school and my most recent endeavor as an advanced practice nurse practitioner student as the Milwaukee Black Nurses Association celebrated its 30th Annual Scholarship Awards Program. Dr. Sandra Underwood was the keynote speaker at the scholarship awards program. Dr. Underwood discussed the challenges of African-American students in nursing school. I sat next to a colleague who graduated nursing school thirty years ago. She was the only African-American nursing student to graduate from her class. Minority students, today, face the same type of scenario; being the only minority student in their classes and to graduate from nursing school. I have experienced similar struggles being the only minority student in many of my nursing courses and the only minority registered nurse on my unit at the institution I am employed at. I find it disheartening that students face the same challenges in educational institutions across the United States and in our workplace that nurses experienced over 30 years ago. The nursing profession has had many successes and came a long way but there is still so much more to be done as it relates to support, mentoring, inspiring and advancing the role of nursing among minorities. I feel so humbled and grateful to have wonderful mentors who have provided inspiration and support throughout my nursing career. I feel that having a mentor is so important to the success of students in nursing because there is such a lack of support in many educational and workplace institutions for minority students. I feel honored to have been the recipient of the United Health Foundation scholarship award among other support provided by the local and national chapter of the National Black Nurses Association. It is a blessing to be a part of such an amazing organization that provides resources, mentoring, support and works to uplift and advance the nursing profession as a global and diverse field. In my role as a registered nurse and my future role as an advanced practice nurse it will be my priority to give back to a community that has supported me throughout this entire journey. I hope to become a mentor and catalyst for change to improve outcomes, retention and support for minority nurses in academia and in the workforce. Harpreet Singh-Gill, RN, is a student in the Master of Science in Nursing program at Alverno College of Nursing. She is expected to complete requirement in December 2014.

NBNA.org — 31 Reflections on the NBNA Conference Kimberly Ayers, RN Member, Birmingham Black Nurses Association

A

s a Birmingham Black Nurses Association (BBNA) member, I have been introduced, exposed, and invited to participate in many of the National Black Nurses Association (NBNA) events. It was not until I attended the NBNA Annual Conference in New Orleans, LA, that I realized what a dynamic, intellectual, personable, comprehensive, and energetic organization I am privileged to be a member. The conference was like no other and I have attended quite a few professional nursing conferences. Not only did the NBNA provide a plethora of up-to-date/peer-reviewed information, it was provided in a loving and comfortable environment. When I registered for the conference I did not book my room (I waited until I was sure of the exact date that I would arrive) and as a result, the hotel was booked when shortly after I attempted to book. NBNA immediately took action to remedy the situation. The organizers negotiated rooms in hotels that were located in close proximity to the hotel where the conference was held. When I called the national office, I was calmly and reassuringly told, “We are making appropriate arrangements.” When hearing a slight amount of panic in my voice, I was told, “Don’t worry, we are going to make sure you’re in a nice hotel with nice accommodations. We are not going to have you staying in anything less.” This really did put my mind at ease. The fact is, NBNA made arrangements for those who were staying in a hotel other than the conference hotel, to be transported to and from the conference at the appropriate times. I felt assured that things would be ok. The actual preconference was rich with information on writing from scholars, professors, editors, and other knowledgeable and friendly people. I was happy that I registered for the writing workshop. We were provided group and individual guidance and information on articles and work that we brought with us at no additional cost. This is something that is normally an additional cost for at other conferences but we had access to the authors and instructors; they all clearly wanted to be there. These authors enjoyed mentoring, guiding, and teaching us as we were obviously hungry for tips and information that would propel us forward into the literary world or improve on our established writing and publishing skills. The next session that I was absolutely impressed with was; Mental Health First Aid. Initially, I was not sure if this session would provide me with new information because I have been a mental health nurse for more than 15 years and nurse for more than 22 years. I have acquired a great deal of knowledge around behavioral and mental health. I read the information regarding the session and understood that the material provided would be related to teaching those who have no knowledge of mental health and as a matter of fact, those who have false and misinformation. I know that education and advocacy is necessary in regards to mental health therefore I registered for this session and promised by superior that I would return with some skills to share with our non-mental health staff. I had no idea that I was going to be showered with so much practical and easy to implement evidence based practices that would

allow me to teach small group sessions. These sessions would help give people a better understanding of how not to respond and how to respond when they encounter a mental health emergency. Much attention is given to cardio pulmonary resuscitation (CPR) without much thought but a mental health emergency can be life threatening just as cardiopulmonary arrest. An individual who is hallucinating and/or delusional must have appropriate intervention to prevent injury to him or herself and/ or to prevent injury to anyone else. Providing basic information on what mental illness is and steps to take when you are in the presence of someone experiencing a life-threatening episode is astounding and obviously necessary. We understand that as health care professionals, nurses in particular, we are responsible to first do no harm and in order to remain true to that promise, it is crucial that we are armed with the tools to fulfill our obligation. This session was so information packed and interactive (which is certainly important for information retention) that the demand was greater than the resources—-as a mental health nurse that makes me happy. I did not receive the book that was given in this session (again, the demand was greater than the supply) therefore I have requested it in order to begin to share some of the nuggets with my staff, church members, and anyone who will listen. This was an impressive session and I do hope this will be an option at the conference next year. There were numerous other sessions that added new knowledge for clinicians. The session on providing care in the penal system and the one with the parish nurse were filled with people who are passionate about what they do. Admittedly, I am not very social as far as getting dressed and going out (especially as I was in the middle of finals week) but the events that were provided were regal events. These events provided the opportunity to network with and get to know my fellow NBNA members in a relaxed/typical New Orleans style; delicious food and great music. I met several nurses who live in different parts of the United States and since I went to school in New Orleans, I ran into some people I met while I was a student at Dillard University. This conference was one of, if not, the best that I have attended and I plan to return next year with a thirst for more. I am not a terribly emotional person but I was brought to tears with the military nurses and the march of the officers and leaders of the organization. I understand the need for those who are passionate about ensuring that African American nurses are not only kept in the loop of current information but are involved to the degree of writing articles, teaching nursing students, managing and directing health care centers, advocating for patient rights and being leaders in the dynamic force of strong health care providers.

32 — NBNA.org

NBNA Chapter News

Members on the Move

NBNA.org — 33 Northern New Jersey Black Nurses Association

Dr. Deidre Walton, NBNA President, in attendance at the American Heart Association’s Inaugural Faith-Based Roundtable. Dr. Walton is pictured with (left to right) Dr. Ronald Copeland, Kaiser Permanente, Oakland, CA, and Marvin L. Winans, Pastor, Perfecting Church, Detroit, MI.

Black Nurses Association of the First State

Dr. Deidra Walton with Rosemary Allen-Jenkins, President, and members of the Northern New Jersey Black Nurses Association at the 2013 Annual Scholarship Brunch held in November 2013.

Dr. Deidre Walton is pictured with NBNA members including (center) Norma L. Rodgers, BSN, RN, CCRA President, IFN/President-Elect, NJSNA. President Walton visited Delaware State University in November 2013. Dr. Walton is pictured with Dr. Marsha Horton, Interim Dean of the College of Education, Health and Public Policy. Dr. Walton’s visit included a tour of the campus, meeting with Dr. Harry Lee Williams, University President, Dr. Alton Thompson, Provost/Academic Affairs, and the Dean. Dr. Walton conducted a round-table with students; highlighting the effects of the IOM report on the Future of Nursing on future nurses.

Pittsburgh Black Nurses in Action Congratulations! to Claudia Kregg-Byers, PhD, RN, for completion of her Doctor of Philosophy degree program. Dr. Kregg-Byers’ dissertation was titled, “Predictors of Food Security in Older Adults Living in the Northeast United States.” Dr. Kregg-Byers is a GAANN Fellow (Graduate Assistance in Areas of National Need).

Little Rock Black Nurses Association The Little Rock BNA held its Symposium and Annual Scholarship Award event Sept. 14, 2013. Presentations were conducted by Keneshia Bryant, PhD, APRN, FNP-BC (NBNA Board Member) and Rochelle McFerguson, BSN, RN. Dr. Bryant presented, “Managing My Life... Managing My Stress.” Rochelle presented, “Implementing Sexually Transmitted Infection Screening.” The 2013 Jacqueling JonesGibson & Carolyn Smedley Scholarship recipient was Janina McIntosh, SN, (left) at Baptist School of Nursing in Little Rock.

34 — NBNA.org Concerned Black Nurses of Central New Jersey Barbara Sunnerville, RN, received the Maysie Stroock outstanding Bedside Nurse Award for 2013. Barbara has worked for the Saint Barnabas Health Care System for over 25 years.

NBNA Chapter News Dorothy Stiggers, MSN, RN, was televised on Oct. 13, 2013 by the Kentucky Educational Department on her Theory and Clinical Instructor at AVI-Richard J. Daley College. The CNA students were televised performing their clinical skills of bed making, measuring vital signs height/weight, and transferring using the gait belt. Dr. Janice Phillips, Associate Professor, Adult Health and Gerontological Nursing, Rush University College of Nursing, was selected as a guest on the Tom Joyner Morning Show on Wednesday, September 25, 2013. Dr. Phillips discussed National Breast Cancer Awareness Month on behalf of Susan G. Komen during the Get Well segment.

New York Black Nurses Association Chicago Chapter National Black Nurses Association CCNBNA members appreciate the NBNA Proclamation from Dr. Deidre Walton, NBNA President. Azella Collins, MSN, PRP, presented the proclamation. Shirley Howard, PhD, Judy Powell, Jiles GeorgeTaylor, Charlene Curtis, and Toni L. Oats, RN, were recognized for mentoring LPN students with the Health Care Jobs in the Southland program/grant. Daisy Harmon-Allen, PhD, and Toni L. Oats, RN, have been seated on the Womens’ Auxillary Board of Roseland Hospital. Dr. Daisy Harmon-Allen (left) has been a Parish Nurse over a decade. She received the Parish Nurse Award from Black Nurses Day under the leadership of Dr. Sandra Webb-Booker in 2008. On Oct. 18, 2013, Dr. Harmon-Allen received her certification as a Parish Nurse Instructor in Indianapolis, IN. Congratulations! to Jerrilyn Pearson-Minor, EdD, RN, (left) on receiving the Doctor of Education degree. Dr. Pearson-Minor is the Director of Nursing for the Department of Children and Family Services for the State of Illinois. Dr. Daisy Harmon-Allen, CCNBNA President and members of the chapter, presented Dr. Pearson-Minor with a trophy depicting knowledge on November 11, 2013, at her award’s ceremony in Alsip, IL. Dora Clayton Jones, MSN, RN, presented a paper titled, “Religiosity and Spirituality in Adolescents with Sickle Cell Disease,” at The Interdisciplinary Conference on Health, Religion and Spirituality at Indiana State University on Nov. 9, 2013. Gayle Disu, BSN, RN, was a panelist on the topic, “Affordable Care Act vs Single Payor,” on Oct. 28, 2013, at the play, “Mercy Killing,” site University of Chicago.

Hayward Gill, Jr., was the recipient of the Lifetime Achievement Award by Dr. Deidre Walton, NBNA President, at the NBNA Conference in New Orleans, LA. Stacey Johnson, RN, received the Maria Dudley APN scholarship Award. The Bronx International Family Day, sponsored by NYS Assemblyman Mark Gjonaj, 80th AD, was held on Aug. 18, 2013 and attended by Marcia Skeete, Mirian Moses and Jean Straker. Jean represented Barbados and took part in a television interviewed by Channel 12 Bronx News. Nelline Shaw represented Antigua and Barbuda. Certificates were given to the two NYBNA members who represented their Country. Bernice Headley and Mirian Moses attended the Ribbon Cutting Ceremony for the Henry J. Carter Specialty Hospital & Nursing Facility in East Harlem in August 2013. This facility replaces the Goldwater Specialty Hospital in Roosevelt Island.

NYBNA member were invited to participate in the Katie Couric Show, September 6, 2013, on ABC Television NetworkNYC “Racism in American”. Program guest included: Tavis Smiley, the parents of Trayvon Martin, the mother of Oscar Grant (a true story of his life told in the movie Fruitvale Station). NYBNA members who attended were (l to r) Jacquetta Miller Whaley, Nellie Bailey, Hayward Gill, Jr., and Marcia Skeete. Jean Straker and Alicia Mitchell of John Hus Moravian Church participated in Good Health Brooklyn Faith Walk “Get Moving Brooklyn Day” in Prospect Park, Brooklyn, NY on Sept. 14, 2013.

Members on the Move

NBNA.org — 35 C. Alicia Georges, EdD, RN, FAAN, was the keynote speaker at the Caribbean American Nurses’ Association (CANA) Bronx, Manhattan, Westchester Chapter Annual Scholarship Luncheon on Oct. 12, 2013.

Sept. 15, 2013: The African American Day Parade in Harlem, NY, was held on September 15, 2013. NBNA President, participated in the parade with members of NYBNA. (left to right) Hayward Gill, Jr., Shakima Wiggins, (driving) Mirian Moses, and Dr. Deidre Walton.

Other members attending were Jean Straker, Imani Kinshasa, Bernice Simmons, Deborah McHugh, Marcia Skeete, Azsha Matthews, Nelline Shaw, Sabrina Newton, Akini Moses, and Stephanie Pierre. Other supporters of the chapter participating were Hyacinth McKenzie, President BNA Queens Chapter, and Denise Mitchell, marching annually in honor of her mother, the late Barbara Michell, who was a member of NYBNA. Lincoln Hospital Auxiliary, Inc., Annual Gala was held on Sept. 26, 2013 at Maestros in Bronx, NY. Mirian Moses, Chair, spoke on the behalf of the importance of volunteering on Bronx 12 TV news. In attendance were Jean Straker, Etta White, Imani Kinshasa, Bernice Headley, Joyce Fowler, and Dr. Wesley Willis. A reception for Ghanaian Nurses Leadership, an extension of, NYU Leadership Institute for Black Nurses under the leadership of Yvonne Westley held at the NYU African House. Mirian Moses and Harriet Brathwaite (Direct NBNA member) advisory board members were in attendance. Imani Kinshasa provided blood pressure screening at NYS Dormitory Authority for their staff members on October 8, 2013. Imani also participated in The Breast Cancer Walk at Orchard Beach Bronx, NY on Oct. 20, 2013.

Departmental of Environmental Protection (DEP) Agency, NY, invited NYBNA to participate in their Health Fair for their staff members in Corona, Queens NY. Hayward Gill, Jr., presented on Prostate Cancer (Above) and provided information to DEP staff member. NBNA Members: Jean Straker, Hyacinth McKenzie (President BNA Queens Chapter), Mirian Moses, and Marcia Skeete were captured providing information on depression to DEP. The event was held on Oct. 23, 2013.

Jasmin Waterman and Imani Kinshasa (not pictured) are providing instructions on self-breast examination on breast model.

Shakima Wiggins, Jasmin Waterman, Patrician Mclean, and Cirse Scotland participated in the DC 37 Health Fair in Manhattan (New York City).

36 — NBNA.org

NBNA Chapter News “FunnyMaine” Johnson’s jokes and amusing situations entertained the audience and lightened the mood. Legendary nursing professionals recognized for their notable contributions were: Doreen Harper, Dean and Fay B. Ireland Endowed Chair in Nursing, and Director of the PAHO/ WHO Collaborating Center for International Nursing at the University of Alabama at Birmingham School of Nursing and Beatrice Price, RN, Retired, a Tuskegee Airman Nurse, and Congressional Gold Medal of Honor recipient whose nursing career spans over sixty-nine years. Nurses nominated by their colleagues receiving Heroes in Healthcare Awards were: Helen Jeanette Clopton, RN, Retired, a strong Nurse from the Civil Rights Movement era who possessed exemplary leadership and clinical skills and Kermillia Moorer-Whitehead, RN, Children’s of Alabama, who over her 25 year nursing career has embraced her natural-born leadership qualities.

NYBNA celebrated its 42nd Anniversary Annual Dinner Dance and Scholarship awards Gala at Antun’s in Queens Village, NY on Nov. 9, 2013. Shown in the photo above (L to R): Jean Straker, President, Imani Kinshasa, scholarship committee chair, scholarship recipients Lejeune SealeyHorsford and Shamika Wiggins, Patricia Ann McLean and Hayward Gill, Jr., scholarship committee members.

Birmingham Black Nurses Association Birmingham BNA was recently asked to participate in a city-wide community event called “Party with a Purpose.” This is an annual event coordinated by Birmingham City Councilman, Steven Hoyt. Activities at the event included a Career Expo, Education and Literacy Fair, Kidz Korner, Evangelism, Entertainment, Golf and Tennis Instructions and a Health Fair. Deborah Andrews, MSHSA, RN, Immediate Past President of BBNA, was the Chair of the Health Fair and Blood Drive for this event. BBNA members provided education and counseling on Breast Cancer Awareness (Martha Dawson, DNP, RN, FACHE), SIDS (Valencia Vann, RN-CLNC), and Diabetes (Mary Williams, MSN, RN, BBNA-President Elect). BBNA also manned the First Aid Station. Deborah Andrews writes, “We saw people with elevated blood sugars, low blood sugar, elevated blood pressures, scrapes and cuts, heat exhaustion and low blood volume after donating blood. Our team quickly went into action as the first responders to a person who passed out, we subsequently sent him off by ambulance. (We did hear from his family that he was released later that evening). We were especially proud of Alean, Adam and student nurse Ashley for their quick response and use of critical thinking skills. City Councilman Hoyt was very appreciative of our group and all of the active participation at this year’s event. This was one more testament of why BBNA is vital to our community and sure to grow as an organization while impacting lives!” Birmingham Black Nurses Association presented its 4th Legends in White Gala on Saturday, Nov. 2, 2013 at the Hyatt Regency Birmingham/The Wynfrey Hotel. Sarah Verser of Fox Six News served as the Program Moderator. Souled Out Band, one of the Southeast’s most exciting and soulful cover bands, captivated the audience through their artistic music. Photographic memories of the gala were captured by Andra Walker of There It Is Photography. With his glowing personality, southern charm, youthful spirit, and endless talent, Jermaine

Birmingham Black Nurses Association presents their 2013 Scholarship recipients: Everett L. Harris, Jamonica Watson, Juanita Jones, Whitney J. Law, Maya A. Brown, & Thomas C. Sargent. Martha A. Dawson, DNP, RN, FACHE, has been selected to join the American Nurses Association workgroup that will engage in an intensive work effort (9-12 months) to review and revise the 2009 nursing administration scope and standards publication. Dr. Dawson recently co-authored an article: (Wilson, L. A., Crooks, E. A., Day, W.S., Dawson, M. A., et al. (2013)). “Global perspectives on nursing leadership: Lessons learned from an international nursing and health care leadership development program.” Journal of Nursing Education and Practice, 4(2), 140-152. Dr. Dawson joined the Alabama Health Action Coalition (AL-HAC) as a grant writer, fund developer, and co-lead on the Diversity Initiative. She is the coinvestigator on the Robert Wood Johnson (RWJ) State Implementation Project Grant. Dr. Dawson is the 2013-14 President of the Birmingham Regional Organization of Nurse Leaders.

Members on the Move Martha A. Dawson, DNP, RN, FACHE, Coordinator for Nursing and Health Systems Administration and the faculty is pleased to share that the Nursing and Health Systems Administration (NHSA) Program at the University of Alabama at Birmingham School of Nursing (UABSON) was ranked #10 by US News and World Report. This is the second time the NHSA Program has ranked in the top 10 under Dr. Dawson’s leadership. The NHSA program at UABSON is also one of the fastest growing nursing leadership programs in the nation. Dr. Dawson, Assistant Professor, has been appointed as an adjunct faculty at the University of Alabama at Huntsville and the University of Alabama at Tuscaloosa in the graduate programs. Deborah Andrews, MSHSA, RN, was recently awarded for servant leadership by AlaONE (Alabama Organization of Nurse Executives) for serving as “Director at Large” for the past 5 years. Deborah has served on various AlaONE subcommittees over the years and found this to have been a rewarding and enriching experience. Congratulations to Adam Smith, RN, on being accepted into the Nurse Practitioner Program at Samford University. Attorney Carthenia Jefferson was honored by receiving the leadership award at the Awards banquet on October 10th at the Alabama State Nurses Association 100th Anniversary held at the Renaissance Hotel & Spa, Montgomery, AL Theresa Flint Rodgers, DNP, CPNP - AC/PC, was invited to speak at the 27th Annual North America Cystic Fibrosis Conference. The conference was held in Salt Lake City, UT on Oct. 17-19, 2013. She presented the unique case, “A Patient with End Stage Lung Disease,” in the Advance Practice Caregivers Session. The goal of the session was to present interesting challenges to caring for pediatric and adult patients with cystic fibrosis. Kathryn Jackson, MSN, RN-BC, was highlighted as the member of the month at the monthly Evidenced Practice and Research meeting. Kathryn is a nurse at UAB Hospital in Birmingham, AL. She is also Adjunctive Clinical Nursing Faculty at UAB School of Nursing. Kathryn is an active participant in the Geriatric Scholar Program, a Certified Medical Surgical Nurse, Level III in the Professional Nurse Development Program. The Birmingham BNA is proud to announce that Dr. Stephanie Davis Burnett is the editor of the newly published resource, “Evidence- Based Rehabilitation Nursing: Common Challenges and Interventions.” This newly published manual is an excellent resource and a must have for the rehabilitation nurse’s library. This second edition of the Evidence-Based Rehabilitation Nursing: Common Challenges

NBNA.org — 37 and Interventions provide an extensive review and analysis of the science and research that functions as the foundation for rehab nursing. The book explores seventeen common patient problems and presents them in a format and style that is easy to read and understand with the goal of impacting the application of evidence based knowledge into practice. Nursing practice now considers research and evidence based practice as an essential nursing competency at all levels. The Association of Rehabilitation Nurses selected the contributors of this publication for their knowledge, skill, and expertise in the field of rehabilitation and in the practice of the research process. Dr. Burnett and colleagues should be congratulated for an excellent job of presenting this very useful information. Four exceptional University of Alabama at Birmingham School of Nursing alumni and professional leaders are 2013 inductees into the Alabama Nursing Hall of Fame. The induction ceremony took place Thursday, Oct. 10, 2013, at the Bryant Conference Center at the University of Alabama in Tuscaloosa. One of the inductees was Dr. Delois Skipwith Guy. Excerpts from articles written about her: Delois Guy, DSN, first African-American faculty member at the UAB School of Nursing, devoted her nursing career and academic pursuits to compassionate service for those who needed it most. Throughout her 26-year career as a nursing educator, she served as a department chair, professor, assistant professor, instructor and research scientist. She is recognized as a national leader in research dealing with aging and the elderly. She earned her DSN degree from the UAB School of Nursing in 1980. Delois Guy dedicated her nursing career and academic pursuits to compassionate service for those who needed it most. Her journey started in Tuscaloosa at what was then called Druid City Hospital (now DCH Regional Medical Center) and held other positions in Tuscaloosa, Tuskegee and Birmingham. Overcoming multiple barriers, Guy became the first African-American faculty member at The University of Alabama at Birmingham School of Nursing and its first African-American tenure-track professor. During her 26-year career as a nursing educator, she served as a department chair, professor, assistant professor, instructor and research scientist. She has often been described as a national leader in research dealing with aging and the elderly. Even in retirement, she has actively continued her research work, which shows her earnest desire to improve the quality of life for others. The Alabama Nursing Hall of Fame was established in 2001 by the Board of Visitors at Capstone College of Nursing. It was created to recognize nurses who have brought honor and pride to the profession and the State of Alabama. The Hall of Fame is governed by the Alabama Nursing Hall of Fame Board comprised of members of University of Alabama’s Board of Visitors. This body establishes the criteria for selecting inductees and the methods for determining eligibility for and election to the Hall of Fame. Nominations for induction into the Hall of Fame are submitted to a selection committee of the Alabama Nursing Hall of Fame Board. Dr. Guy is a member of NBNA, BBNA and has donated money toward the scholarship fund.

38 — NBNA.org

NBNA Chapter News

Congratulations to Alean Nash, MHA, RN, who completed the Master’s in Healthcare Administration program from Walden University. Alean is the charge nurse in the Endoscopy unit at UAB hospital in Birmingham, AL. Lindsey Harris, MSN, FNP-BC, has been appointed as a member of the UAB SON Alumni Chapter Board for 2013-14. Lindsey is a Nurse Practitioner on the Diabetes Management Team at UAB Hospital in Birmingham, Alabama.

Southeastern Pennsylvania Area Black Nurses Association Karen King Shannon, RN, Immediate Past President, joined Dr. Lucy Yates in providing invaluable nursing support during the M-O-M Dental Mission 2013 at Temple University where fillings, root canals, cleanings, mini partial dentures and dental health literacy was provided for approximately 1800 clients in the Philadelphia area. Congratulations again to Cynthia Byrd Wright, RN, CDE, who successfully gained certification as a Diabetic Educator and Smoking Cessation Educator. Dr. Lucy Yates presented on diabetes and conducted stroke risk assessments during a Community Health Workshop at Ezekiel Baptist Church in Philadelphia, PA. Dr. Yates continues to administer free Influenza injections in her community this fall season.

Black Nurses Association of Greater Washington, DC Area To Promote Knowledge and Understanding of the Institute of Medicine (IOM) Blueprint for the Future of Nursing: Leading Change, Advancing Health and its Impact on African American Nurses in the District of Columbia (DC)

The BNA of Greater Washington DC Area (BNAGWDCA) Program Committee developed a four-part education programmatic agenda for the year to ensure that our members know and understand the 2010 Institute of Medicine (IOM) Report, “Future of Nursing: Leading Change, Advancing Health” and its ramifications for the DC nursing workforce. Additionally, members are made aware that the RWJF/AARP Campaign for Action partnership was established to mobilize nurses in the 51 states and the District of Columbia to form Action Coalitions to operationalize the IOM recommendations. The DC proposal was approved (January 2013) for the establishment of the DC Action Committee (DCAC). DCAC held a Forum, Nov. 7, 2013, University of the District of Columbia (UDC), “Evolving Healthcare Leadership in the Era of the Affordable Care Act through Diversity and Inclusion”. The goals of DCAC included, introducing the DCAC to the healthcare community. Local universities, hospitals, churches and professional organizations were in attendance. BNAGWDCA member, Pier Broadnax, PhD, RN, Director of Nursing, UDC is the Nurse Co-Lead, DCAC. Other Co-Leads are Rev. Roy Thomas, Pastor, Nazareth Baptist Church and Jehan (Gigi) El Bayoumi, MD, Director, Rodham Institute, George Washington University. In addition, BNAGWDCA Vice President, Sonia Swayze, MA, RN, Senior Project Manager, Communications and Outreach, Patient Safety Staff, Food and Drug Administration and BNAGWDCA member Karen Skinner, RN, MSN, Executive Director, Board of Nursing, DC Department of Health are members of the Executive Committee of DCAC. The DC Action Coalition Forum provided an important discussion as prelude to the BNAGWDCA Program Agenda for 2013-14. The Program Agenda is composed of four one hour programs and will offer continuing education units (one contact hour for each program). The Program Agenda is co-sponsored with the Children’s National Medical Center.

Milwaukee Black Nurses Association Dr. Deidre Walton was one of the workshop presenters at the Philippine Nurses Association of America, Wisconsin, Educational Conference. Pictured on the far left is JoAnn Lomax, and Sharon Coffie (center), members of the Milwaukee Black Nurses Association.

NBNA.org — 39

Members on the Move BNAGWDCA Program Committee Members are Patricia Tompkins, RN, MS, Acting Chair, Diana Wharton, BSN, RN, President; Sonia Swayze, MA, RN, Vice President; Barbara J. Patterson, MA, RN; Mourine Evans, RN-BC; Margaret Nelson, LPN Janice Johnson, BSN, RN-BC; Tonya Jackson, BSN, RN; Gwendolyn Johnson, MA, RNC; Crystal Scott, MSN, RN; and Barbara Baskerville, MSN, RN. BNAGWDCA 2014 Program Agenda March 1, 2014 Topic: Diversity Through Nursing Education, Policy, Practice, Research and Leadership: “Increase the Proportion of Nurses with BSN to 80% by 2020” Presenter: Pier Broadnax April 24, 2014 Topic: Ensure Nurses engage in Lifelong Learning: “Certification and other Competency Programs” Presenter: TBD June 26, 2014 Topic: Advance Practice Registered Nurses Presenter: Barbara J. Hatcher, RN, PhD

Atlanta Black Nurses Association The Atlanta Black Nurses Association (ABNA) recently celebrated its Thirty-Fifth Chapter Anniversary in grand style! Organized in 1978 and chartered in 1980, NBNA’s 8th Chapter has a long history of, “Magnifying Health Awareness,” in the city and surrounding areas of Atlanta. Sharing in the festivities was Rev. Dr. Deidre Walton, NBNA President, and six of ten past Presidents; each of whom provided personal reflections and words of encouragement. The chapter’s Founder and President Emeritus, Dr. Darlene Ruffin-Alexander, a past NBNA Board member, shared an eloquent oral history of the organization and the NBNA President presented a beautiful proclamation. In keeping with their tradition to support and mentor students, ABNA presented two scholarships to deserving students completing both a BSN and PhD program. Congratulations! to Eugenia Jennings, RN, on her retirement from Grady Health Systems on June 30, 2013 after 30+ years of outstanding service. Congratulations to the following ABNA members for their awards from NBNA at the 41st NBNA Annual Institute & Conference in New Orleans: Betsy L. Harris, NBNA Lifetime Achievement Award; Eugenia Jennings, NBNA Administrative Nurse of the Year; and scholarship awardees: Ambra J. Jordan, Jamil E. Davis and Charles Edge. ABNA continues to support the Atlanta community through health fairs and taking advantage of the opportunity to provide education: Member participation is pivotal and included: n Real Men Cook (June 13): Cassandra Milton, Mary Dawson and LaTonya Hines n Greenforest Baptist Church (July 13): Emma Knight, Mary Dawson, Pat Allen and Cassandra Milton n New Life Community Church (July 20): Mary Dawson, LaTonya Hines, Emma Knight, Cassandra Milton, and Evelyn C. Miller

n

Lou Walker Senior Center Health Fair for Women (Sept 11): Mary Dawson, Pat Allen and Emma Knight n Lou Walker Senior Center Health Fair for Men (Sept 18): Betsy Harris, Mary Dawson and Evelyn Houston Bell n Veterans Health Fest at Clayton County International Park/ Rock Baptist Church (Oct 5): Tennille Hicks and Ursula Wright n Pleasant Hill Baptist Church (Oct 12): Cassandra Milton, Mary Dawson and LaTonya Hines; Lindsey Street Baptist Church: Patrice Brown; The City of Riverdale Breast Cancer Awareness Event: Laurie Reid n Ryan Cameron Foundation 6th Youth Health Fair Glucose and Cholesterol Screening (Nov 13): Johnnie Lovelace and Cassandra Milton n Congressman David Scott Annual Health Fair at Mundy High School (Aug 17): Members of ABNA assisted the providers with breast exams and directing women to the portable mammogram vehicle. Breast exams were done on 221 women. ABNA members who assisted were Pat Allen, Emma Knight, Kandice Naggie, Patrice Brown, LaTonya Hines, Mary Dawson, Johnnie Lovelace, Brenda Cherry, Bianca Woodall-Jones, and Evelyn C. Miller. Beverly Dinkins-Learmont, NP, performed breast exams along with other providers at the event. Educational events attended by members were: National Kidney Foundation education training on your kidney and you (June 20th) Mary Dawson, LaTonya Hines and Bianca Woodall-Jones. The training was a pilot program to equip the trainees to go into the community and present information on kidney health to community groups. ABNA members Laurie Reid, Karen Rawls, and Evelyn Houston Bell went to Georgia Perimeter College’s Nursing Orientation/boot camp information to talk with nursing students and to encourage them to join ABNA and NBNA. Betsy Harris, Past ABNA President, attended Jen Care Neighborhood Medical Clinic opening on Sept. 12. The clinic will provide senior citizens with free health care and medication. ABNA presented Coffee and Conversation Understanding Health Care Reform Beyond October on Sept. 12 at Bauder College. Amanda Ptashkin, JD, Outreach and Advocacy Director Georgians for a Healthy Future was the speaker. Laurie Reid, ABNA President, attended Partnership Against Domestic Violence Conference on Oct 13. Evelyn C. Miller, Evelyn Houston Bell, Bianca Woodall- Jones and Patrice Brown attended the Surgeon General panel held on October 3rd titled, “Underserved and High Risk Population in the United States: Taking Action for Comprehensive Primary Healthcare Renewal.” Seven Surgeons General spoke on Preparing Leadership for Health Equity including David Satcher, Boris Lushniak, Regina Benjamin, Kenneth Moritsugu, Richard Carmona, M. Joycelyn Elders and Antonia Novello. Evelyn C. Miller, ABNA President attended the National Hispanic Medical Associates Affordable Care Act presentation and reception at Emory Conference Center on Oct. 11. Past ABNA President, Betsy Harris, attended the Emory Alzheimer’s Forum at the Carter Center on Oct. 29. Laurie Reid, ABNA Past President, attended the Heath Action Network luncheon presentation for Georgians for a healthy future on the health insurance exchange on Oct. 30.

40 — NBNA.org The American Heart Association sponsored the Power to End Stroke Ambassador Awardee’s reception at Pascal’s Restaurant Nov. 7. Laurie Reid past president of ABNA and Mary Dawson, Vice President of ABNA were honored for their community service with the American Heart Association/ American Stroke Association.

Back row L to R: Evelyn Miller, Dr. Darlene Ruffin-Alexander, Dr, Marcia Wells, Dr. Deidre Walton, Ora D. Williams Front Row L to R: Betsy Harris, Laurie Reid Below: Atlanta BNA members enjoying the President’s Gala at the 41st NBNA Conference in New Orleans, LA

NBNA Chapter News Mississippi Gulf Coast Black Nurse Association

Romeatrius Moss, DNP, RN, APHN-BC, Executive Director, was the recipient of the Community Health Excellence Award at the Denim & Diamonds Reception for the Tri-Regional Faith and Community Health Summit. The keynote speaker was Kendall Simmons, a former NFL player, living with diabetes. Rita Wray, MBA, RNC, FAAN, was appointed to the Board of Trustees by the DeVry, Inc./Chamberlain College of Nursing. The Board is the institutional governing body for Chamberlain, overseeing academic, operational and financial policies. Board responsibilities include advancing Chamberlain’s vision and mission, establishing new or changing existing academic programs and providing expertise on the nursing profession and on issues that impact the healthcare industry. Wray, founder and CEO of W.E., Inc., a national independent healthcare consulting firm. Rita is a former member of the NBNA Board of Directors as a past Treasurer and Historian.

The Mississippi Black Nurse Association hosted a breast health education and clinical breast exam community event in September 2013. Co-host included the World Wrestling Entertainment (WWE), Susan G. Komen, and Memorial Physician Clinics. The following were provided to the community: Breast Health Education; Breast Cancer Risk Screenings; Clinical Breast Exams; $100 Digital Mammogram Certificates; and Tickets to WWE event & Giveaways! Dr. Romeatrius Moss is pictured at the Race for the Cure with Governor, First Lady and Susan G. Komen President.

Members on the Move

Dr. Romeatrius Moss was the recipient of the Great 100 Awards at the FNA Membership Assembly. The award was presented at the Great 100 Awards Gala on Friday, September 20th in Orlando, FL.

Black Nurses Association, Miami Chapter Dr. Marie O. Etienne was selected as a 2013 recipient of the Florence Nightingale Medal. Given every two years, the Florence Nightingale Medal, awarded by the International Committee of the Red Cross, celebrates the contribution of nurses and nursing aides to the work of the International Red Cross and Red Crescent Movement. It is given to nurses who distinguish themselves in time of peace or war by their exceptional courage and devotion to victims of a conflict or disaster, or through exemplary services in the areas of public health or nursing education. It is the highest international nursing distinction within the Red Cross.

NBNA.org — 41

Dr. Marie O. Etienne is a professor in the School of Nursing at Miami Dade College, where she was the recipient of the Stanley G. Tate 2007 Endowed Teaching Chair. She serves on the American Red Cross National Nursing Committee as the representative for the National Black Nurses Association, and she is a member of the Red Cross Scientific Advisory Council (SAC) and the Sub-Council on Nursing and Care-giving. Born in Haiti, she came to the U.S. at age 14, earning a bachelor’s degree, a master’s degree as a pediatric nurse practitioner, a post-master’s certificate in Advance Family Practice and Gerontology and a Doctorate of Nursing Practice. Dr. Etienne has led numerous missions, including several trips to the Dominican Republic, where she provided nursing care for migrant sugarcane plantation workers. She has served as past president of the Haitian American Nurses Association of Florida and the past chairwoman of the Haitian American Professionals Coalition. In these capacities, she traveled to Haiti after the 2010 earthquake to care for survivors. She continues to make return trips to promote both physical and mental rehabilitation for individuals affected by the devastating earthquake. NBNA congratulates Dr. Etienne for this distinguished honor.

42 — NBNA.org Nevada Black Nurses Association Congratulations to Debra A. Toney, PhD, RN, NBNA Past President. Dr. Toney was elected to serve on the board of directors for the American Academy of Nursing.

Council of Black Nurses, Los Angeles Eric J. Williams, DNP, RN, CNE, NBNA 1st Vice President, was elected to the board of directors for the American Assembly for Men in Nursing. Linda Burnes Bolton, DrPH, RN, FAAN, was chosen as President-elect of the American Organization of Nurse Executive (AONE).

Black Nurses Association of Baltimore Danielle Houston, BSN, RN, Secretary BNAB, completed the Bachelor of Science in Nursing degree from the BarnesJewish College Goldfarb School of Nursing in St. Louis, MO. Danielle graduated Summa Cum Laude and was inducted into Sigma Theta Tau Honor Society of Nursing.

NBNA Chapter News National Black Nurses Association 2014 Election Criteria

I

n the even numbered years the 1st Vice President, 2nd Vice President, Treasurer, There (3) Board Members at-large, the Student Representative and three (3) members of the Nominating Committee are to be elected.

All candidates must demonstrate evidence of having implemented the philosophy, goals, and objectives of the National Black Nurses Association, Inc. on a local or national level. Except for the Student Representative, all board candidates must have attended three (3) NBNA Conventions in the last five (5) years, one of which was the previous year. The Nominating Committee nominees must have attended two (2) NBNA Conventions in the last four (4) years. First Vice President • Hold a valid license to practice or is retired • Graduate of an accredited school of nursing • Has a minimum of five (5) years experience in nursing • Has full command of the English language • Has previous organizational leadership experience • Is a member of a chapter or is a direct member • Has served on a chapter committee

Tasha Brown, BSN, RN, Financial Secretary BNAB, was successful on the NCLEX.

• Has served as a chapter board member • Has demonstrated evidence of participation in community activities (church, school, civic) • Has the flexibility in work enabling him/her to attend Board and executive committee meetings • Has other nursing organization experience • Has served in previous leadership positions

Michelle Hayward, BSN, RN, was successful on the NCLEX. Nerland Robinson, RN, was honored with placement on the Dean’s List at Notre Dame of Maryland University. Nerland was honored at the University’s Convocation on September 28, 2013. Patty Palmer, RN, former NBNA Student Representative, achieved outstanding academic achievement at South Georgia State College and was placed on the Dean’s List.

• Has previous NBNA Board experience • Has served in the capacity of president of local chapter or other nursing organization (preferred not required) • Has management/administrative experience • Has previously served as an officer of NBNA • Has worked on several NBNA committees • Has demonstrated ability to speak to global issues concerning the health care industry, health regulation and policy; health delivery, health care professionals and consumers

NBNA.org — 43

Election Criteria Second Vice President

• Has served on a chapter committee

• Hold a valid license to practice or is retired

• Has served as a chapter committee member

• Graduate of an accredited school of nursing • Has a minimum of five (5) years experience in nursing • Has full command of the English language • Has previous organizational leadership experience • Is a member of a chapter or is a direct member

Board Member –at- large • Graduate of an accredited school of nursing • Hold a valid license to practice or is retired • Has a minimum of one year in nursing (clinical, teaching, or administrative)

• Has served on a chapter committee

• Has full command of the English language

• Has served as a chapter board member

• Is a chapter member or direct member

• Has demonstrated evidence of participation in community activities (church, school, civic)

• Has served on a chapter committee

• Has the flexibility in work enabling him/her to attend Board and executive committee meetings • Has other nursing organization experience • Has served in previous leadership positions • Has previous NBNA Board experience • Has served in the capacity of president of local chapter or other nursing organization (preferred not required) • Has management/administrative experience • Has worked on several NBNA committees • Has demonstrated ability to speak to global issues concerning the health care industry, health regulation and policy; health delivery, health care professionals and consumers Treasurer • Has demonstrated knowledge, skill, and expertise in fiscal management

• Has served as a chapter committee member • Has demonstrated evidence of participation in community activities (school, civic, or church) Student Representative • Is an unlicensed student enrolled in an accredited RN or LPN/LVN program • Able to remain in office one school year before graduating • Has served on boards of directors locally or within student organizations • Is a member of a chapter • Has full command of the English language • Has demonstrated evidence of participation in community activities • Has a minimum “C” average Nominating Committee Member

• Has served as an officer or board member of a local, regional, or national organization

• Graduate of an accredited school of nursing

• Graduate of an accredited school of nursing

• Has a minimum of one year experience in nursing

• Has a valid license to practice or is retired • Has a minimum of three years experience in nursing

• Has served as an officer, board member or member of a nominating committee on a local, state, or national level

• Has full command of the English language

• Has full command of the English language

• Is a chapter member or direct member

• Is a chapter member or director member

• Has demonstrated evidence of participation in community activities (school, civic, or church)

• Has demonstrated evidence in participation in community activities (school, civic, or church)

• Has other nursing organizational experience

• Has attended at least two (2) NBNA Conventions in the last (4) years

• Has a valid license to practice or is retired

• Has flexibility in work enabling him/her to attend Board and Executive committee meetings.

• Has served as a chapter officer/board member

• Has served in previous leadership positions

• Has served on a Nominating Committee of a chapter

• Has attended at least three (3) NBNA Conferences in the last five (5) years; one of which was the previous year

• Has served on a Nominating Committee of another organization

If you are interested in being of service to NBNA, request an application from the NBNA office by calling 301-589-3200 or send an email to [email protected]. Complete the application and send it back to [email protected] AND [email protected].

44 — NBNA.org

NBNA Chapter Websites

ALABAMA

Birmingham BNA.......................................................... www.birminghambna.org

ARIZONA

Greater Phoenix BNA.................................................... www.bnaphoenix.org

CALIFORNIA

Bay Area BNA............................................................... www.babna.org Council of BN, Los Angeles........................................... www.cbnlosangeles.org Inland Empire BNA........................................................ www.iebna.org San Diego BNA............................................................. www.sdblacknurses.org South Bay Area of San Jose BNA.................................. www.sbbna.org

COLORADO

Eastern Colorado Council of BN (Denver)...................... www.coloradoblacknurse.org

CONNECTICUT

Northern Connecticut BNA............................................ www.ncbna.org Southern Connecticut BNA........................................... www.scbna.org

DELAWARE

BNA of the First State................................................... www.bnaoffirststate.org

DISTRICT OF COLUMBIA

BNA of Greater Washington DC Area............................. www.bnaofgwdca.org

FLORIDA

BNA, Miami.................................................................. www.bna-miami.org BNA, Tampa Bay.......................................................... www.tampabaynursesassoc.org Central Florida BNA...................................................... www.cfbna.org First Coast BNA (Jacksonville)....................................... www.fcbna.org St. Petersburg BNA....................................................... www.orgsites.com/fl/spnbna

GEORGIA

Atlanta BNA.................................................................. www.atlantablacknurses.com Concerned NBN of Central Savannah River Area........... www.cnofcsra.org Savannah BNA.............................................................. www.sb_na.org

HAWAII

Honolulu BNA............................................................... www.honolulublacknurses.com

ILLINOIS

Chicago Chapter NBNA................................................ www.chicagochapternbna.org

INDIANA

BNA of Indianapolis....................................................... www.bna-indy.org

KENTUCKY

KYANNA BNA (Louisville).............................................. www.kyannabna.org Lexington Chapter of the NBNA..................................... www.lcnbna.org

LOUISIANA

Baton Rouge BNA......................................................... www.mybrbna.org Shreveport BNA............................................................ www.sbna411.org

MARYLAND

BNA of Baltimore.......................................................... www.bnabaltimore.org

NBNA Chapter Websites

NBNA.org — 45

MASSACHUSETTS

New England Regional BNA.......................................... www.nerbna.org

MICHIGAN

Greater Flint BNA.......................................................... www.gfbna.org Saginaw BNA................................................................ www.bnasaginaw.org

MINNESOTA

Minnesota BNA............................................................. www.mnbna.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 Central New Jersey........................... www.cbncnj.org 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 Westchester BNA.......................................................... www.westchesterbna.org

NORTH CAROLINA

Central Carolina BN Council.......................................... www.ccbnc.org

OHIO

Cleveland Council of BN................................................ www.ccbninc.org Columbus BNA............................................................. www.columbusblacknurses.org Youngstown-Warren (Ohio) BNA.................................... www.youngstown-warrenobna.org

OKLAHOMA

Eastern Oklahoma BNA................................................ www.eobna.org

PENNSYLVANIA

Pittsburgh BN in Action................................................. www.pittsburghblacknursesinaction.org Southeastern Pennsylvania Area BNA............................ www.sepabna.org

SOUTH CAROLINA

Tri-County BNA of Charleston....................................... www.tricountyblacknurses.org

TENNESSEE

Nashville BNA............................................................... www.nbnanashville.org

TEXAS

BNA of Greater Houston............................................... www.bnagh.org Metroplex BNA (Dallas)................................................. www.mbnadallas.org

WISCONSIN

Milwaukee Chapter NBNA............................................. www.mcnbna.org

NBNA CHAPTER PRESIDENTS

46 — NBNA.org ALABAMA BIRMINGHAM BNA (11) Dr. Jennifer Coleman Birmingham, AL MOBILE BNA (132) Dr. Yolanda Turner Mobile, AL MONTGOMERY BNA (125) Tonya Blair Montgomery, AL ARIZONA GREATER PHOENIX BNA (77) Angela Allen Phoenix, AZ ARKANSAS LITTLE ROCK BNA OF ARKANSAS (126) Cheryl Martin Little Rock, AR CALIFORNIA BAY AREA BNA (02) Nesha Lambert Oakland, CA COUNCIL OF BLACK NURSES, LOS ANGELES (01) Dr. Lovene Knight Los Angeles, CA INLAND EMPIRE BNA (58) Kim Anthony 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 DELAWARE BNA OF THE FIRST STATE (133) Eunice Gwanmesia Dover, DE 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) Dr. Lenora Yates Miami Gardens, FL BNA, TAMPA BAY (106) Rosa Cambridge Tampa, FL

CENTRAL FLORIDA BNA (35) Constance Brown Orlando, FL CLEARWATER/ LARGO BNA (39) Audrey Lyttle Largo, FL FIRST COAST BNA (JACKSONVILLE) (103) Sheena Hicks Jacksonville, FL GREATER GAINESVILLE BNA (85) Voncea Brusha Gainesville, FL PALM BEACH COUNTY BNA (114) Dr. Louise Aurelien West Palm Beach, FL ST. PETERSBURG BNA (28) Janie Johnson St. Petersburg, FL GEORGIA ATLANTA BNA (08) Evelyn C. Miller, RN College Park, GA COLUMBUS METRO BNA (51) Gwendolyn McIntosh Columbus, GA CONCERNED NATIONAL BLACK NURSES OF CENTRAL SAVANNAH RIVER AREA (123) Dr. Beulah Nash-Teachey Martinez, GA SAVANNAH BNA (64) Wanda Jones Savannah, GA HAWAII HONOLULU BNA (80) Dr. Patricia Burrell Aiea, HI ILLINOIS CHICAGO CHAPTER BNA (09) Dr. Daisy Harmon-Allen 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 KYANNA BNA, LOUISVILLE (33) Brenda Hackett Louisville, KY LEXINGTON CHAPTER OF THE NBNA (134) Penne Allison Lexington, KY

BAYOU REGION BNA (140) Ellen Matthews Thibodaux, LA NEW ORLEANS BNA (52) Trilby Barnes-Green New Orleans, LA SHREVEPORT BNA (22) Carletta Lamb Shreveport, LA MARYLAND BNA OF BALTIMORE (05) Dr. Ronnie Ursin Baltimore, MD BN OF SOUTHERN MARYLAND (137) Kim Cartwright Temple Hills, MD MASSACHUSETTS NEW ENGLAND REGIONAL BNA (45) Margaret Brown Roxbury, MA WESTERN MASSACHUSETTS BNA (40) Gloria Wilson Springfield, MA MICHIGAN DETROIT BNA (13) Nettie Riddick Detroit MI GRAND RAPIDS BNA (93) Earnestine Tolbert Grand Rapids, MI GREATER FLINT BNA (70) Sonya Jackson Flint, MI KALAMAZOO-MUSKEGON BNA (96) Birthale Archie Kentwood, MI SAGINAW BNA (95) Archia Jackson Saginaw, MI MINNESOTA MINNESOTA BNA (111) Shirlynn LaChapelle Minneapolis, MN MISSISSIPPI CENTRAL MISSISSIPPI BNA (141) Tangela Hales Brandon, MS MISSISSIPPI GULF COAST BNA (124) Dr. Romestrius Moss Gulfport, MS MISSOURI GREATER KANSAS CITY BNA (74) Iris Culbert Kansas City, MO NEBRASKA OMAHA BNA (73) Dr. Aubray Orduna Omaha, NE

LOUISIANA

NEVADA

ACADIANA BNA (131) Jeanine Thomas Lafayette, LA BATON ROUGE BNA (135) Tonya Washington Nash Slaughter, LA

SOUTHERN NEVADA BNA (81) Ann Hall Las Vegas, NV

NEW JERSEY

SOUTH CAROLINA

CONCERNED BN 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 MIDDLESEX REGIONAL BNA (136) Cheryl Myers Plainfield, NJ NEW BRUNSWICK BNA (128) Barbara Burton New Brunswick, NJ NORTHERN NEW JERSEY BNA (57) Rosemary Allen-Jenkins Newark, NJ SOUTH JERSEY CHAPTER OF THE NBNA (62) Gail Edison Williamstown, NJ

MINORITY BNA OF FLORENCE, SC (139) Dr. Rhonda Brogdon Florence, SC TRI COUNTY BNA OF CHARLESTON (27) Dr. Debbie Bryant Charleston, SC

NEW YORK NEW YORK BNA (14) Jean Straker New York, NY QUEENS COUNTY BNA (44) Hyacinthe McKenzie Cambria Heights, NY WESTCHESTER BNA (71) Altrude Lewis-Thorpe Yonkers, NY NORTH CAROLINA CENTRAL CAROLINA COUNCIL (53) Helen Horton Durham, NC SANDHILLS NORTH CAROLINA BNA (138) LeShonda Wallace Fayetteville, NC OHIO AKRON BNA (16) Sandra Lee Flowers Akron, OH BNA OF GREATER CINCINNATI (18) Marsha Thomas Cincinnati, OH CLEVELAND COUNCIL BNA (17) Peter Jones Cleveland, OH COLUMBUS BNA (82) Pauline Bryant Columbus, OH YOUNGSTOWN WARREN BNA (67) Lynn Hines Youngstown, OH OKLAHOMA EASTERN OKLAHOMA BNA (129) Phyllis Collins Tulsa, OK PENNSYLVANIA PITTSBURGH BN IN ACTION (31) Jacqueline Blake Pittsburgh, PA SOUTHEASTERN PENNSYLVANIA BNA (56) Juanita Jones Philadelphia, PA

TENNESSEE MEMPHIS-RIVERBLUFF BNA (49) Linda Green Memphis, TN NASHVILLE BNA (113) Shawanda Clay Nashville, TN TEXAS BNA OF GREATER HOUSTON (19) Angelia Nedd Houston, TX FORT BEND COUNTY BNA (107) Charlie Terrell Missouri City, TX GALVESTON COUNTY GULF COAST BNA (91) Leon McGrew Galveston, TX GREATER EAST TEXAS BNA (34) Pauline Barnes Tyler, TX METROPLEX BNA (DALLAS) (102) Dr. Becky Small Dallas, TX SOUTHEAST TEXAS BNA (109) Denise Sanders Boutte Port Arthur, TX VIRGINIA BNA OF CHARLOTTESVILLE (29) Dr. 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

The

Dream is Golden