In principle, a novel pathogen like COVID-19 should affect everyone equally. But very early in the pandemic, it became clear that this was not the case. Once the disease was established in the United States, Black and Native American communities were hit especially hard and continue to suffer disproportionate harm today.

As the Centers for Disease Control and Prevention and others have explained, these divergent outcomes are due to social determinants of health, or SDOH; understanding these factors is an essential part of responding to public health crises. That’s one reason why disaster preparedness was a significant focus of the National Academy of Medicine’s report The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. The report calls on nurses to understand how addressing social determinants can make communities more resilient in the face of disaster.

But the Wisconsin Center for Nursing had already undertaken that work a year before the report was released, with support from the Future of Nursing: Campaign for Action’s Nursing Innovations Fund. The Campaign is an initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation that is building a healthier America through nursing.

“We just got there early,” said Barbara Nichols, MS, RN, FAAN, executive director of the Wisconsin Center for Nursing.

Nichols and her team developed “Nurses Respond Now,” a training course meant to prepare working nurses to understand the needs of vulnerable populations during public health disasters.

The course had its origins in a survey of the needs of Wisconsin RNs and LPNs. These nurses told the Wisconsin Center for Nursing that their employers did a good job educating them in the basics of disaster preparedness. But they felt less competent when it came to the more general topic of public health crises and how they intersect with health equity.

“What I’m pleased by is that we developed the course based on data about what nurses said they did and didn’t have,” Nichols said.

The project was initially piloted with 37 nurses caring for vulnerable populations in Milwaukee, then developed into a continuing education course available to nurses throughout the state. Partners in sharing the curriculum included the Rural Wisconsin Health Cooperative, the Wisconsin Primary Health Care Association, and the Bellin School of Nursing in Green Bay.

Nichols says the team is also looking at additional approaches to getting the word out, including the development of a “masterclass” for nursing school faculty.

The course addresses two central themes: the need to identify vulnerable populations in public health crises and the specific role nurses can play in serving them.

“The nurse has a specific role in responding to public health emergencies, and if nurses are prepared, the hospitals and communities they are a part of will do a better job,” she said. “The course helps you connect those dots. It makes you a better practitioner.”

Some of the “dots” connected by the course were identified by program exit surveys. More than 90 percent of nurse participants said that after the course they could explain the specific impacts of COVID-19 on vulnerable communities, use social determinants of health as a framework to analyze their needs, and provide care in spite of their own unconscious biases.

The course also served as a platform to discuss systems-level changes that nurses desire in their communities. Many participants said that they wanted to see their organizations develop specialized teams devoted to addressing the social determinants of health, or new resources frontline nurses can access.

More generally, Nichols said she saw the course as a way for Wisconsin’s nurses to become more comfortable discussing the topic of race. More than 85 percent of the state’s population is white; more than 90 percent of the nurses are as well, she said.

“You could live in Madison and never come into contact with a Black person, even though there are 10,000 of us,” she said.

For other organizations looking to make a similar impact on health equity issues, Nichols’ advice is simple: start with data. By asking the state’s nurses what they needed, the Center was able to make more effective use of its funds.

“You don’t necessarily need a lot of money to be impactful if you are focused,” she said.

Read more about the Campaign’s Nursing Innovations Fund and Wisconsin’s program.

The post Wisconsin Nurses Lead in Disaster Preparedness appeared first on Campaign for Action.

When nurses are empowered to create health equity in their communities, they bring together a network like nobody else can.

The Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation, has demonstrated this principle through its Nursing Innovations Fund that supports the Campaign’s state-based Action Coalitions in creating replicable and promising solutions for improving health equity through nursing.

The Nursing Innovations Fund was also designed to spark collaboration with partners outside of nursing. One condition of the award is that applicants must seek matching funds from other organizations. In combination with other tools to engage local stakeholders, the awards have led to an impressive array of new multi-sector relationships, helping nurses discover new allies for creating better access to care and services.

Launched in 2018, the Nursing Innovations Fund has led to new projects in 23 states. The Campaign has awarded more than $850,000 to a wide variety of initiatives, with every dollar being matched by other funders. This blog highlights the collaborations and projects from the 2019 and 2020 cohorts representing 17 states, whom created over a dozen publicly accessible tools to be used for building health equity. All of the resources are available on the Campaign website.

State coalitions secured investment from multiple organizations that understand why it is so important to invest in better access to care and services. They include organizations one might expect, such as hospitals, nursing schools, and regional philanthropies. Action Coalitions also secured funding from unexpected sources:

• In Georgia, funding from the Clayton County Fire and Emergency Services helped create more effective paths for Black men to enter nursing.  
• In Kentucky, the Kentucky Beef Council supported an initiative to prevent suicide in the farming community, and
• In Nebraska, Scoular, an agriculture supply chain company, contributed matching funds to a project aimed at improving health equity.

In addition to funders, Action Coalitions garnered critical support from community partners representing dozens of different organizations. Here are a few of their stories:

• In Pennsylvania, a podcast highlighting nurses in health equity roles featured many local partners, including Sanctuary Farm, a program that converts abandoned areas in Philadelphia to farm plots.
• In Washington, a program to bring culturally appropriate food and essentials to older Filipino community members worked with local and national groups such as the National Alliance for Filipino Concerns.
• In Indiana, nurses from the Indiana Center for Nursing collaborated with the AARP state office to enable nursing schools across the state to implement holistic admissions programs

Crucial to the impact of these projects is the idea that all of them can provide insights that help many other organizations disrupt disparities and improve access to care and services.

Actions Coalitions drew on well-established tools to address health disparities, including the Campaign’s Heath Equity Toolkit and the Centers for Disease Control and Prevention’s (CDC) Healthy People 2030. In turn, many of them developed new resources to help others:

• In Wisconsin, the Action Coalition developed a curriculum to improve nurses’ disaster response capabilities, and it is being shared throughout the state.
• In Massachusetts, nurses developed an anti-vaping resource kit for use in public schools.
• The Pennsylvania initiative centers on a podcast that helps nurses envision new careers in health equity.

Together, these partnerships, resources, and insights add up to a powerful network working to achieve health equity in the U.S. built on strengthened nursing capacity and expertise, as the National Academy of Medicine’s Future of Nursing 2020—2030 report has envisioned.

In the coming weeks, this Campaign blog will feature more detailed explorations of how this work brought together local and state coalitions to address health equity. Projects to be featured include:

• Indiana – This project brought together partners including AARP Indiana State office and Orbis Education to help nursing programs implement holistic admissions and peer-to-peer mentoring for the Nursing Education, Engagement, and Diversity Statewide Initiative, or NEEDS.
• Kentucky – The Kentucky Nurses Action Coalition enlisted school nurses to address the state’s disproportionate suicide rate, culminating in a dramatic presentation designed with the Actors Theater of Louisville. Title: School Nurses to BARN Camp for the Mental Health and Wellness of Kentucky Youth.
• Massachusetts – This project addressed vaping in youth in partnership with education and law enforcement groups from across the state, yielding new curricula to aid teachers in elementary and secondary schools. Title: Promoting Health Literacy to Influence Health and Wellness of Students in the Community: Widening the Connections.
• North Carolina – Working with the North Carolina Action Coalition, the North Carolina Agricultural and Technical University developed a new model of coalition-building to help African American and rural communities. Title: Project RARE (Reciprocal, Authentic, Relationships for Equity).
• Wisconsin. The Wisconsin Nurses Center explored gaps in the state’s emergency preparedness plans, then developed a training to help nurses address the problems. Partners included nursing schools as well as the Rural Wisconsin Health Cooperative and the Wisconsin Primary Health Care Association. Title: Preparing Wisconsin Nurses to Address the Needs of Vulnerable Populations in a Public Health Emergency.

Previous blog entries have also explored Nursing Innovations Fund programs in Pennsylvania, West Virginia, and Wyoming.

Are you interested in addressing health equity in ways like the Campaign’s Action Coalitions? Visit the Nursing Innovations Fund page for a complete list of programs as well as the Campaign resources nurses used to create them.

The post Nursing Innovations Funds Stimulate Partnerships appeared first on Campaign for Action.

The Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP, and the Robert Wood Johnson Foundation (RWJF), is pleased to announce that 10 projects proposed by its state-based Action Coalitions, or in a few cases, organizations designated by an Action Coalition, have been selected to receive awards up to $25,000 each for new or ongoing work that strengthens nursing’s role in building a Culture of Health and promoting health equity. All 2020  Nursing Innovations Fund secured dollar to dollar matching funds from a variety of partners, including local county fire and emergency services, a state beef council, United Way, local foundations, health and hospital systems, universities and individual donors, to name a few.

The winning projects from nearly every region of the country range from developing nurse leaders to serve on local boards to a mentoring program for Black men that promotes educational attainment and employment opportunities in nursing. All are designed to address policies that impact the many different social, economic and environmental factors that shape our health, and that will lead to greater health equity for all.

RWJF defines health equity as, “everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments and health care.”

“As a co-chair of the Campaign’s Equity, Diversity and Inclusion Steering Committee (EDISC),

I am proud that these 2020 Nursing Innovation Fund projects are committed to advancing health equity, particularly at a moment when our nation is finally paying increased attention to addressing systemic racism,” said Carmen Alvarez, PhD, CRNP, FAAN, assistant professor, Department of Community-Public Health, Johns Hopkins University.

“A pathway to equity is to help build better health through nursing,” said Eric J. Williams, DNP,  RN, FAAN, assistant director and faculty chair and professor of nursing at Santa Monica College, and fellow co-chair of the EDISC. “These efforts are a step in that direction and I applaud the Action Coalitions for their work.”

The Campaign’s Nursing Innovations Fund was created in 2018 to support work of its Action Coalitions and allies that inform and influence policy, produce replicable strategies that place nurses in positions as essential partners in providing care, and strategically involve a diversity of stakeholders. This competition was limited to the Action Coalitions or organizations designated by Action Coalitions and required applicants to raise funds to match the award dollars. To date, 23 Action Coalitions and allies have received Nursing Innovation Fund awards to build healthier communities through nursing.

“As our nation continues to face the devastation wrought by COVID-19, nurses remain on the frontlines as trusted providers of care. Now, more than ever, our country is relying on nurses to apply their unique knowledge and understanding of community needs for better health. These states demonstrate how nurses use that critical perspective to implement innovative programs to improve health and well-being,” said Susan B. Hassmiller, PhD, RN, FAAN, senior adviser for nursing at RWJF and director of the Campaign for Action and Susan C. Reinhard, PhD, RN, FAAN, senior vice president and director of the AARP Public Policy Institute, and chief strategist at the Center to Champion Nursing in America, an initiative of AARP Foundation, AARP, and RWJF, which coordinates the Campaign for Action.

The winners and an overview of their proposals are listed below:

Arkansas and Tennessee

The Arkansas Center for Nursing and the Tennessee Action Coalition aims to develop nurse leadership and places nurses on local housing and planning boards throughout the Arkansas Tennessee Delta region, to help create healthier communities through the project, “Nurses Building a Culture of Health in the Arkansas-Tennessee Delta”. This geographic area has a history of inequities, poverty and poor health outcomes. Matching funds were provided by the Arkansas State Board of Nursing, the Tennessee Department of Health and the Tennessee Housing Development Agency.

Georgia

The Georgia Nursing Leadership Coalition plans to implement a mentoring program for Black men that promotes educational attainment and employment opportunities in nursing through the “High School to Higher Education: Increasing Black Male Representation in Nursing” project. The efforts will engage community partners as stakeholders and employ a holistic approach to providing professional and personal development opportunities to assist mentors and mentees build the skills needed for educational attainment and employment success.

Kentucky

The Kentucky Nurses Action Coalition’s project, “Kentucky Partners to the BARN (Bringing Awareness Right Now) Program for a Farmer Dinner Theater Addressing Mental Health & Wellness” is a three-part intervention program designed to help address farmer mental health issues and prevent suicide. Fifty high school students with an agricultural career interest will receive tailored training sessions to raise self-awareness about mental health and wellness, learn suicide prevention skills and theater skills to produce a dinner theater addressing mental health and wellness for approximately 100 Kentucky farmers and their families.

Nebraska

The Nebraska Action Coalition’s project, “Striving for Health Equity in Nebraska,” works to address social determinants through a multipronged approach.

1. Build professional students’ knowledge of population health by having them design and disseminate health information at school health fairs.
2. Develop community-based partnerships via an advanced practice registered nurse led clinic which provides integrated behavioral health care for rural and underserved populations.
3. Promote awareness and build partnerships through an annual Leadership/Culture of Health conference. The conference will address topics such as advocacy, policy, mental health/self-care, implicit bias, and it will also include a “COVID-19 Lessons Learned” panel.

North Carolina

North Carolina Agricultural and Technical State University’s project, “On the Ground: Access to Care through Building Faith, Health, and Community Partnerships,” supported by the North Carolina Action Coalition, seeks to develop a faith, health, and community engagement model utilizing the Campaign’s Health Equity Toolkit. The program aims to enhance the health equity advocacy and partnership/coalition building skills of nurses, nursing students, pastors and church members to promote the health and well-being of communities through congregations. It will also create a regional steering committee to engage stakeholders to prioritize and address social determinants of health that adversely affect the health and well-being of African American and rural communities, and promote health-related congregational activities focused on the needs of the community.

Pennsylvania

Through its “At the Core of Care” podcast, the Pennsylvania Action Coalition will showcase stories of nurses and their partners driving change by addressing social determinants of health. The series will be incorporated into nursing school classrooms to inspire public health leadership and advocacy.

Washington

The National Alliance for Filipino Concerns launched the “Bayanihan Response to COVID-19″ to respond to the immediate and long-term health and wellness needs of Filipino communities in the United States and the Philippines. Via a telephone weekly check in and screening with elders identified as high need, callers assess for COVID-19 symptoms, food, prescription, utilities, housing needs and pre-paid phone minutes. They also offer a grocery and meal delivery program to ensure clients have access to nutritious and culturally appropriate food.  Lastly, they will conduct a community wellness survey. Focus group results will be disseminated to community members, stakeholders, and the public. In collaboration with Seattle University College of Nursing, and support of the Washington Action Coalition, they will use survey data to create interventions and initiatives to address community needs.

West Virginia

The West Virginia Action Coalition project, “RN Entrepreneur Project Continuation,” will create five sustainable nurse businesses and teach the entrepreneur course to 20 additional nurses. The training curriculum and program will expand across the state.

Wisconsin

The Wisconsin Action Coalition’s project, “Preparing Wisconsin Nurses to Address the Needs of Vulnerable Populations in a Public Health Emergency”, will design and develop trainings for Wisconsin nurses in response to the specific educational needs created by COVID-19. Trainings will address disparities impacting Wisconsin’s most vulnerable populations. Components include: launching educational programs for Milwaukee nurses who care for diverse and vulnerable populations, evaluating and improving learning content and methodologies and expanding the program statewide.

Wyoming

The aim of the Wyoming Institute for Disabilities, University of Wyoming, in support with the Wyoming Action Coalition project, “Facilitating Seniors’ Use of Technology to Decrease Social Isolation,” is for nursing students to help older adults use technology in their homes to access health care, purchase groceries and household goods, and communicate with their friends and family.

The post 2020 Nursing Innovations Fund Award Winners appeared first on Campaign for Action.

The post How Closely Do Wisconsin’s RN Graduates Reflect the State’s Diversity? appeared first on Campaign for Action.

When journalists and nurses connect, powerful stories can emerge.

A nurse and a reporter attend a talk about Alzheimer’s disease. They are in the audience; they don’t know each other. A few weeks later, and not by chance, the nurse’s name appears print, putting a small dent in the abysmal statistics about nurses in health news coverage.

The reason: Julie Lepianka, MSN, RN, made a point of going to talk to Milwaukee Journal Sentinel journalist Mark Johnson, and she didn’t hide her passion for her work. Lepianka, an assistant professor in the College of Nursing & Health Sciences at Milwaukee’s Cardinal Stritch University, had brought her students to the talk so they could learn about the emotional toll Alzheimer’s takes on families. Johnson was there to write a story about former Wisconsin Gov. Marty Schreiber, who now spends his days caring for his wife and talking about the need to treat people with Alzheimer’s disease with dignity.

When the presentation was over, Lepianka introduced herself to Johnson and invited him to attend her “Spiritual Health” course. In the class, nursing students role-play tough discussions—a tumor is cancerous, a much-wanted baby isn’t viable—with theater students playing the roles of patients. The result: a front-page article in the Sunday Journal Sentinel, “We Need to Talk: How Doctors and Nurses Learn the Harrowing Task of Delivering Bad News to Patients.”

Nurses Are Still Underrepresented in the Media

Front-page coverage of nurses’ work is unusual. Very, very few are included or quoted as experts. In fact, it’s unusual for news coverage to include nurses’ insights at all: According to The Woodhull Study Revisited: Nurses’ Representation in Health News Media, nurses were quoted in just 2 percent of health-related newspaper articles and 1 percent of articles in health care publications in September 2017.

Stritch University nursing professor Julie Lepianka turned a chance encounter with a reporter into a front-page story about delivering bad news to patients.

When Lepianka approached Johnson, her intent was not to correct decades of media invisibility. She simply wanted to share the techniques she has found most useful in teaching nurses to treat patients and families humanely. “I’m very passionate about just how important it is to have compassion in health care,” Lepianka says.

Johnson followed up because, as he puts it, “There’s usually a good story when somebody is very passionate about something they do.”

But all too often, reporters—and therefore the public—don’t witness the intensity and drive many nurses bring to their work. Johnson says that hospital media relations personnel routinely offer physicians as sources and rarely refer reporters to nurses. Additionally, some nurses are leery about talking to reporters.

“I think we are humble to a fault,” Lepianka says. “We confuse passion and knowledge with ego. So many of us are fearful of coming off as boastful or obnoxious if we share the important work that we do.”

Fortunately, at least some reporters are aware of the wisdom of including nurses’ perspectives.

“I’ve found that nurses often have a better view of the ground level—what the patient’s family is going through, how the patient is doing,” Johnson says. “The doctor may see the patients on rounds, but the nurses see them for hours.”

Lepianka suggests that nurses can overcome their hesitancy by reframing their actions. “Nurses are huge patient advocates. If we really took our patient advocacy role seriously, we would be much more vocal about the work we do, because, in the end, sharing our story benefits the patient.

“I have a responsibility as an advocate for my patients to speak up and have my voice heard.”

How You Can Become More Media Friendly

The front-page Journal Sentinel article was the result of Lepianka’s deliberate action. Here’s what she did—and what you can do—to be more media friendly:

• Be bold. Lepianka introduced herself to Johnson: “I remember that I hustled to get his attention.”
• Connect your expertise to a topic of interest. Lepianka drew a direct line between Schreiber’s talk and her work, pointing out that both are about the need to treat human beings with dignity and respect. Johnson had been wondering how health care providers discuss difficult subjects with patients. Lepianka’s suggestion he visit her class gave him the opportunity to learn more, and positioned nurses as experts.
• Share your enthusiasm. Lepianka’s enthusiasm is what persuaded Johnson to visit her class. Don’t hide your excitement, anger, or tears; allow your emotion and dedication to energize your words.
• Introduce yourself to the right people. Lepianka approached Johnson because he was a newspaper reporter. Similarly, she developed a relationship with the communications director at her university because she knows that person fields media requests for expert sources. You can do the same. Introduce yourself to media relations personnel at your place of employment and express your willingness to work with the media.

For more on nurses and the media, read our coverage of the Woodhull Study Revisited, Nurses Remain Largely Invisible in the Media.

The post Speak Up: How One Nurse Turned a Chance Encounter Into a Front-Page Story appeared first on Campaign for Action.

Texas Dashboard Indicator 2: Doctoral Degrees. Retrieved 12/18/2018.

Since the Future of Nursing: Campaign for Action began, it has measured the progress that nursing has made across the U.S. on a national data dashboard. Now at least four  states are creating their own dashboards, using as a yardstick—as does the Campaign—the goals laid out by the Institute of Medicine (now the Health and Medicine Division of the National Academies) in The Future of Nursing: Leading Change, Advancing Health report.

Texas

For example, scroll down the “about” page for the Texas Team: Using information from the Texas Board of Nursing and Texas Center for Nursing Workforce Studies, Texas reports in easy-to-understand graphics how close it’s coming to its 2020 goals in education. The Texas Team also depicts in a bemusing way the roadblocks it has overcome (and still faces) in changing the laws to increase the public’s access to nurse-provided health care.

Nebraska

Bringing the truth about nursing progress home for its residents, too, is Nebraska, which invites website visitors to take a spin through its successes on six indicators. For example, the national data dashboard posted by the Campaign shows the percentage of employed nurses with a baccalaureate (or higher) degree in nursing stands at 54 percent as of 2016. Nebraska’s close-up look shows its percentage as of 2016 stands at 64 percent. (Hooray  for all, but especially slide 3, which celebrates Nebraska’s becoming the 20th state to adopt full practice authority for nurse practitioners.)

Hawaii

Hawai’i has also honed in on its growth toward increasing the percentage of nurses with a bachelor’s or higher. Using data including the 2016-2017 Hawai’i State Nurse Education Capacity Survey, the state forecasts it will achieve the IOM goal of having an 80 percent BSN-prepared workforce more quickly than the nation as a whole.

Wisconsin

Wisconsin lays out its progress points on the Wisconsin Center for Nursing website, including the fact that the number of Badger State nurses with a BSN or higher is about 6 percent higher than the national average.

With strong visuals, leaders in these states can make the case for nursing more easily with information specific to their residents. Congratulations Texas, Nebraska, Hawai’i and Wisconsin for going the extra mile to translate the IOM’s national goals to the state level, making them more accessible for all.

If your state has created its own data dashboard, the Campaign would love to hear from you. Make sure to contact us.

The post A Dashboard of One’s Own: Four States Track Their Successes appeared first on Campaign for Action.

The post Wisconsin Creates Diversity Assessment Toolkit appeared first on Campaign for Action.

• Many students are unaware of financial aid and scholarship opportunities
• Nursing school costs were higher than students anticipated

Wisconsin encouraged nursing schools to increase awareness about tuition costs, financial aid and scholarships through workshops and brochures, as well as individual sessions with school financial aid officers.

The post Wisconsin Survey Identifies Strategies to Increase Recruitment and Retention appeared first on Campaign for Action.

The post Wisconsin Report Highlights State Diversity Work appeared first on Campaign for Action.

The post Wisconsin Produces Dashboard; Shares Progress on IOM Recommendations appeared first on Campaign for Action.