Florence Nightingale, the most celebrated pioneer of the nursing profession, once likened nursing to an art. From Nightingale’s perspective, nursing was, in fact, “the finest of the Fine Arts.” She makes a valid argument. In her analogy, Nightingale aptly compares the work of a nurse to that of a painter or sculptor. Both disciplines require exclusive devotion and hard preparation. Both also incorporate a strong human aspect. Because of this human aspect in nursing, it is important that nursing students exercise skills in the Humanities, particularly writing. Good writing skills in any discipline serve the purpose of promoting individuality, sharper critical thinking skills, and the formation of more articulate thought processes. In nursing, specifically, writing skills help to promote professionalism, credibility, and the dissemination of useful healthcare-based knowledge, which is valuable to hospitals, clinics, and care facilities everywhere.

I am contributing to this blog because I wish people to know why I believe writing is necessary in nursing education. I am well aware that the bulk of nursing students absolutely detests writing and do not share the same opinion as I do. Hopefully through this article, I will have provided a solid argument defending the importance of writing. However, before I expand more on why I believe writing is important to nursing, it should be noted that I might be a little biased due to my academic history. I graduated with a liberal arts degree—more specifically, an English degree. I made the decision to change my career path several years ago, and I am currently more than half-way finished with my second degree in nursing.

But let’s not lie. My initial attraction to the nursing career was a bit more superficial. During my years as an undergraduate student of UC Irvine’s School of Humanities, my goals were much different. I planned on pursuing a career as a music journalist. I dreamed of securing a position at Rolling Stone or Spin. I was determined to get there. However, the sad reality of the music journalism career made itself evident when I applied to a handful of alternative music magazines with no actual success. A long period of taking out odd jobs and engaging in continuous soul-searching prompted me to consider nursing as a way to financially stabilize myself and help provide for my family in the future. It wasn’t the most pure reason for wanting this career, but it’s the truth. I was a girl in her early 20s who loved music, art, and literary prose. I even manned my own radio program as a DJ at Orange County’s KUCI and was heavily involved with the non-profit organization for several years. In the past 5 years, I’m sure that no one would’ve ever guessed that the beats per minute I would be counting would be heart rates, and not the speed of a vinyl record.

However, before you judge me too much about my initial attraction to the stability of the nursing career, please note, that I grew to love it. Why do I love it? Well, while many uninformed people consider nursing to be a mere science, I consider it an art. True, I did graduate with a liberal arts degree, and to many people, this has absolutely nothing to do with nursing. I have a completely different perspective on the relevance of my degree. In my mind, these two different courses of study are similar. The English major analyzes texts from different perspectives in search of literary truths. In a similar vein, the nursing student analyzes data and different variables, from different angles, in search of medical truths in the form of comprehensive diagnoses. I appreciate the multidimensional nature of nursing, and I love the different approaches and interventions that can be taken to address any single problem. Everyday is a constant exercise of critical thinking and creativity.

And believe it or not, I do also love the writing and research aspect that is involved in nursing. Uncovering life-changing data and making a difference in the world through the spread of knowledge and ideas is a very rewarding process that I would like to one day take a part of. For this reason, I’ve always believed that writing is one of the most important aspects of the nursing profession. In fact, according to Provision 7.3 in the Nurse’s Code of Ethics, “…nursing knowledge is derived from the sciences and from the humanities. Ongoing scholarly activities are essential to fulfilling a profession’s obligations to society” (“Code of Ethics,” 2001).

Writing is one of the most important scholarly activities that a nurse can engage in. Eloquence and proficient writing skills in nursing practice indicate competence, expertise, and wisdom in clinical practice. These skills can draw attention not only to the nurse’s expansive and specialized medical lexicon, but also to their extensive knowledge of relevant healthcare-related issues (which proves to be highly beneficial in patient-centered care).

Effective communication skills lend more credibility to the nurse, enabling the nurse to be a more effective and trusted patient advocate. As a result, the nurse may also use her unique writing style to expand and diversify the pre-existing body of healthcare-based knowledge that is used internationally in promoting more effective patient care.

Writing promotes a nursing culture of professionalism and aids in the spread of knowledge and ideas among patients and nurses alike. But if this reason alone is not enough to demonstrate its importance, we must also consider the scarcity of creative assignments in nursing education, which can be all too systematic and structured.

Nursing students rarely get the opportunity to express themselves as individuals. They are mandated to learn the same skills, and they must exercise these skills under a strict protocol. Their form of self-expression is often limited to a mechanical regurgitation of knowledge and hard, scientific facts. Creative processes such as writing promote individuality, critical thinking, and innovation. As nurses, we must exercise writing in order to establish what Theresa S. Drought in The Guide to the Code of Ethics for Nurses describes as “…new ways of understanding disease, health, the human response to illness, and innovations in nursing care” (Drought, 2008, p. 95). Writing is essential for stimulating self-expression, originality, and innovation in a profession that thrives on advanced practice research, evidence based practice, and scholarly inquiry.

Proper writing skills and the exercise of creative thought is paramount to the success of any professional within the healthcare industry. Nursing is certainly not exempt from this. Nursing curriculums often have a heavy emphasis on clinical skills and science-based knowledge. However, what many people fail to realize is that nursing is both a science and an art. Incorporating more writing into nursing education is beneficial because nurses who are strong writers are also strong communicators. Consequently, they are also more vocal patient advocates. As healthcare professionals, we must be aware that the exercise of sharing ideas and contributing interdisciplinary knowledge is a collaborative process that we all should participate in.

If you wish to connect with Sashana, email her at sashanamac@gmail.com.

Volunteers were asked to view paintings by famous and not-so-famous artists and photographs while researcher scanned the volunteers’ brain wave activity using a functional magnetic resonance imaging or fMRI.  Interestingly, the fMRI revealed the ventral striatum of the brain is more strongly activated when viewing a painting rather than a photograph of a similar subject.  Btw, the work of famous artists selected for the study included Monet, Van Gogh, Picasso and others.

According to Krish Sathian MD,  a neurologist at Emory, the ventral striatum and orbitofrontal cortex  (parts of the brain’s reward system) are the areas in the brain that reacts strongly when viewing paintings.  These same areas are also strongly stimulated during high reward behaviors such as drug addiction and gambling.  

Results from the above study is different from other art appreciation studies that used brain scans to examine how the brain responds when veiwing art considered attractive or ugly.  Participants were asked to give a rating based  how well she/he liked it.  These studies have shown that the amygdala, involved in emotional reactions, as well as different regions in the orbitofrontal cortex are involved in aesthetic preference.  See previous post on this study. 

I don’t know how much this matters or even if it’s important, but different areas of the brain are stimulated based on whether one is looking at art for personal preference (aesthetics) and when looking at paintings versus photographs.  In other words, the brain regions activated by paintings (as opposed to photographs) were independent from those brain regions that became active during aesthetic preference.

Interestingly, the results reveal that viewing paintings not only stimulated the ventral striatum, but it also activated the hypothalamus (associated with appetite regulation and other critical functions) and the orbitofrontal cortex (associated with risk-taking, impulse control and detection of social rules).  Assuming these results are correct and can be replicated, a few thoughts arise with regard to incorporating the arts in healthcare…

• If people/patients are engaged in art-making, would the ventral striatum react even more strongly than simply looking at paintings?
• If viewing art stimulates the hypothalamus responsible for appetite (one of many functions), one could assume artwork in healthcare facilities may help patients with poor appetites.
• And lastly, incorporating the arts in healthcare settings will bring about all those associated benefits I wrote about in a previous post, which you can read here.

Source: PsychCentral ”Brain feels rewarded when looking at art.”

Note: The study was inspired by the work of marketing experts Henrik Hagtve and Vanessa Patrick. The original purpose was to explore the effects of using a painting on a product’s advertising/packaging makes that product more appealing.

Vitas Innovative Hospice Care in Miami, Florida has a music appreciation program where volunteers share their musical talents with hospice patients throughout Miami-Dade, Broward and Palm Beach counties.

Volunteers include non-professional singers, certified music therapists, and those with a passion for music and wish to share their talents with patients experiencing end-of-life matters.  According to one certified music therapist volunteer, Jeff Engel, he uses music familiar to patients in order to give them a cognitive workout.  Through his experience,  he found “familiar music and familiar conversation about things that were important to patients many years ago often helps to retard the degeneration of cognitive impairment.”  To read the full story, click here.

In healthcare, scientific evidence of the usefulness or efficacy of medical and non-medical interventions has long been a requirement, and these principles applies to incorporating arts interventions in healthcare.  An article titled “Music Therapy in Hospice and Palliative Care: a Review of the Empirical Data” examines 11 research studies on the effects of music with patients.  Of the 11 studies, 6 are identified as having significant differences supporting the use of music therapy for patients with terminal illnesses.

Reported benefits of music therapy by patients are:

• Significant decrease in pain.  Pre-test and post-test measurements using Short-Form McGill Pain Questionnaire.
• Improvement in mood and anxiety, and decrease in discomforts .
• Increase spiritual well-being.  Many times people with end-of-life conditions request spiritual or religious music.  One study measured spirituality with the 18-item Spiritual Well-Being Scale (SWBS) and completed by patients after each music therapy session.  Analysis showed a significant increase in SWBS scores on the days music therapy was provided.
• Enhanced quality of life.  Interestingly, the more music therapy sessions patients received, higher quality of life is experienced even as their physical condition declined.  The quality-of-life tool used in this study was the Hospice Quality-of-Life Index-Revised (HQOLI), a 29 questionnaire completed by patients.  Source: Hilliard R. Music Therapy in Hospice and Palliative Care: a Review of the Emirical Data.  Music Department , State University of New York, New Paltz, NY.  eCAM 2005; 2(2) 173-178.  doi:10.1093/ecam/neh076

 Although the above studies had small sample sizes thereby limiting generalization, the author of the article, Russell Hilliard, stresses the importance of designing music therapy studies that allow for generalization of the results.  And why is all this scientific inquiry in hospice and palliative care important?  Here are a few reasons:

1. Insurance companies (federal, state and private) seek data/information on the efficacy or effectiveness of a treatment.
2. Because complementary programs such as music therapy, creative programs, etc. need funding, healthcare administrators  need assurance these programs will enhance and raise the standard of care for patients, families and communities.
3. If healthcare organizations truly want to be innovative, creative and provide patient-centered care, then a willingness to explore, experiment and research other avenues of treatment modalities is necessary.  ‘Patient-centered care’ is a call to action, not a trendy catch-all phrase mouthed by the healthcare industry and healthcare professionals.
4. Evidence based practice helps to establish effective treatment interventions or best practices in ensuring high standard of care.

Planetree’s history is equally interesting.  It was founded by Angelica Thieriot in 1978 after her hospital experience battling a rare viral infection.  Back then, hospitals were hardly examples of healing environments that fostered multi-dimensional recovery from illness.  Focus of health care was on treating the disease or ‘sick-care’ rather than ’health-care’ of  patients and families.  The medical model took precedence over patient centered approach leading to a depersonalized and fragmented system, and is how health care functioned for decades.  However, all is not lost!

The Planetree model of care is a “patient-centered, holistic approach to providing patient care, promoting mental, emotional, spiritual, social, and physical healing. It empowers patients and families through the exchange of information and encourages healing partnerships with caregivers. It seeks to maximize positive healthcare outcomes by integrating optimal medical therapies and incorporating art and nature into the healing environment.” (www.planetree.org)

I love Planetree’s simple and eloquent,  yet powerful,  philosophical beliefs.  They (and I) believe…

• that we are human beings, caring for other human beings
• we are all caregivers
• care giving is best achieved through kindness and compassion
• safe, accessible, high quality care is fundamental to patient-centered care

• in a holistic approach to meeting people’s needs of body, mind and spirit
• families, friends and loved ones are vital to the healing process
• access to understandable health information can empower individuals to participate in their health care
• the opportunity for individuals to make personal choices related to their care is essential
• physical environments can enhance healing, health and wellbeing
• illness can be a transformational experience for patients, families and caregivers

To learn more about Planetree, visit them at www.planetree.org.

According to legend, Hippocrates sat under the boughs of the plane tree to teach his pupils the art of medicine.

Lupus or systemic lupus erythematosus (SLE) is a complex, chronic autoimmune disease of the connective tissues in which the immune system attacks itself by developing antibodies leading to widespread inflammation and tissue damage.  It affects nearly every organ in the body, such skin, joints, kidneys, brain, lungs, blood vessels and membranes, and is characterized by unpredictable series of flares and remissions (Medscape, 2010).  Prevalence and incidence of lupus is 3-5 times higher among African-Americans and Hispanics than Caucasians, with women of childbearing age more affected than men (Lim & Drenkard  2008).

Like many chronic diseases, treatment for lupus is focused on symptom management, and more recently, addressing quality of life issues.  In comparing health related quality of life (HRQoL) of patients with common chronic diseases (hypertension, congestive heart failure, adult onset diabetes mellitus, myocardial infarction and depression in the US), the general health  of patients with SLE is significantly lower and affects every area in quality of life (Jolly 2005).  McElhone, Abbott, and Teh (2006) also found SLE patients had HRQoLs comparable to those with severe medical illness, such as AIDS, rheumatoid arthritis and Sjogren’s Syndrome.

Quality of life refers to an individual’s physical, emotional and social wellbeing, including their ability to function in the ordinary tasks of living. It is a personal definition and perspective, one that will vary from person to person despite similar circumstances and disease conditions.  The state of well-being is not only the absence or management of disease, but rather equilibrium between the physical and emotional states as defined by the individual.  Candace Pert is one of the first scientists to recognize that the brain and the immune system might communicate on the molecular level.  In her book, Molecules of Emotion, she explains the bi-directional communication network as “every change in the physiological state is accompanied by an appropriate change in the mental emotional state, conscious or unconscious, and conversely, every change in the mental emotional state, conscious or unconscious, is accompanied by an appropriate change in the physiological state” (Pert  1997). 

  For patients with SLE, outcomes such as fatigue, pain, return to normalcy, physical and emotional well-being are the highest priorities in achieving wellness, and degree of psychological distress was found to be the best predictor of quality of life among patients (Heller & Shadick  2007, Seawell & Danoff-Burg  2004).  By reducing stress and depression, and increasing social support, better health status could be achieved.  Adequate social support is reported to be a protective factor against premature mortality in patients with SLE (Pons-Estel, et al. 2009).

Because of the physical, social and psychological manifestations of SLE, outcome measures should not be confined to just mortality data, disease activity and damage, but include the patients’ perspective on their own health status and quality of life in order to fully understand the whole patient (McElhone, et al.  2006). 

Incorporating the patient’s perspective into the clinical picture is becoming increasingly emphasized.  In 2002, OMERACT’s (Outcome Measures in Rheumatoid Arthritis Clinical Trials) concluded their annual conference with the goal of pursuing research to incorporate the patient’s perspective into outcome assessment (Carr, Hewlett, Hughee, et al. 2003).  Interestingly, the importance of attending to quality of life concerns was addressed by Daltroy & Liang (Harvard Medical School) in 1993.  The need for education, communication, coping skills, social support, pain management, and promoting patient             (Self-portrait painted by a patient) control and diminishing helplessness were highlighted.              

Two studies using visual methods to address the importance of incorporating patient perspective in SLE patients are worth mentioning.  According to Büchi, et al. (2000) perception of disease is a measurable phenomenon, and the Pictorial Representation of Illness and Self Measure (PRISM) offers a quantitative method of measuring the patient’s perception of suffering caused by SLE.  The second study used drawing to understand how lupus was experienced by patients, felt and how the manifestations of the disease influenced patients’ emotions and behaviors (Nowicka 2007).  By providing patients with a sense of control in reaching their personal definition of wellness leads to better outcomes (Heller, et al.  2007).

Assessing patient reported outcomes on health related quality of life (HRQoL)  instruments is one method  is one method of corporating patients perspectives in treating the whole patient. Another useful modality is the use of arts interventions in conjunction with a generic HRQoL assessment tool.  Utilizing art as a non-invasive intervention is another novel way of promoting and incorporating the patient’s perspective in understanding and managing the physical, social and (Self-portrait painted by a patient)              emotional burdens of lupus.

ARTS INTERVENTION

 When the arts are used in health care settings, many define and view the act of creating art as ‘art therapy.’  This needs clarification.  Art therapy is professional one-on-one counseling provided by a licensed art therapist using art materials as the mechanism to facilitate communication between patient and therapist (Malchiodi 2003).  However, the idea that creating art can be a natural healing process is believed by not only art therapists, but artists, health care professionals, and many in the general public.   For use in health care settings, creating art needs to be viewed as a non-professional experiential modality in the context of a holistic framework, whereby the process of creating art is in itself therapeutic.

Here’s a few thoughts and definitions on creativity…

Creativity is marked by the ability or power to create,  to bring into existence, to invest with a new form, to produce through imaginative skill, to make or bring into existence something new. ~Mirriam-Webster

The ability to make new combinations of social worth.  ~John Haefele (CEO and entrepreneur)

The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.  ~Albert Einstein 

Creativity is fundamental to human experience. ~David Bohm

 And here are my thoughts on creativity and the arts in healthcare.  Through exposure and participation in the creative process and the arts, it promotes unity within oneself and with others, be it families, spouses, extended family, and all of those who connect with us.  Creativity and the arts ultimately embraces and promotes social peace.  Engaging in creative activities, whether actively or passively, brings forth…

• compassion
•  tolerance
• kindness
• harmony
• expansion
• growth
• healing on multiple dimensions: body-mind-soul-emotion
• collaboration
• respect

This multi-dimensional healing begins on an individual level and ripples out to include neighborhoods, states, national and global communities.  What happens when you toss a pebble or small stone into calm waters?  It creates ripples or waves in the water  and radiates outward until the energy of the wave dissipates.  Creative activities creates creative energy and momentum, and all its associated benefits.

Creativity  isn’t just about thinking of new strategies to fix old problems or to heal old wounds.  It’s a different way of thinking, which brings about a new way of acting, behaving and interacting with others - it’s a natural and humanistic way of life.  By taking creative action, it can dramatically challenge our existing belief systems, our values, and encourage us to take risks we normally wouldn’t take (both in thought and action). 

Creative actions and creative interventions are what’s needed in healthcare…in patient care…in caring for healthcare professionals and staff…caring for local communities.

Creativity in Healthcare = Healing = Individual and Social Peace

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

A Few Examples of Creative Programs in Healthcare…

Here’s how creativity and the creative process are being implemented in a few health systems.  In U.S. News (2006), a series of articles titled “The Fine Art of Healing the Sick”  highlights a growing trend of using the arts and the creative modalities to help patients alleivate stress, anxiety, provide diversional activities and to heal.  The side benefits of participating, whether active or passive,  vibrates out to include all persons within the healthcare organization…patients, families, healthcare professionals, para-professionals,  staff,  administration, consultants and local communities. 

Here’s a few examples of the methods used to integrate the arts into patient care (but read the U.S. News article!).  (Larson C. The Fine Art of Healing the Sick: Embracing the benefits of writing, music, and art. U.S. News/Best Health, June 5, 2006.)

1. A t the Louis Armstrong Center for Music and Medicine, which is a part of Beth Israel Medical Center in New York, it provides music therapy and researches its effects on children with asthma and adults with cardiac and pulmonary problems, and treats the musicians with medical problems.

2. Tallahassee Memorial Healthcare has medical music therapists providing music therapy sessions to their pediatric patients during diagnostic testing.  The result?  No wiggling, quirming or crying during the test.  No need to repeat tests or extend employee work hours which ultimately saves money for the hospital.

3. Sutter Health System in Sacramento, California offers six writing groups a week through its Literature, Arts, and Medicine Program for patients, caregivers, and the local community.  Studies validate both writing and visual art plays a role in reducing pain and decrease physical symptoms of illness.  One physician who refers many patients to the writing group stated she had a patient with severe asthma and chronic lung disease joined the writing group has improved her symptoms and well-being.  Note: engaging in creative work does not cure physical illnesses, but helps heal on a multi-dimensional level: physically, intellectually, emotionally and spiritually.

These creative programs are part of a growing trend to incorporate writing, music and the visual arts into the clinical treatment of patients, a.k.a  patient care.  Here’s a few other creative interventions to incorporate into healthcare organizations:

• Laughing Clubs

• Artist-in-Residence program

• Writing

• Music

• Dance

• Humor

• Creative exhibits with work created by patients, families, staff and healthcare professionals

• Drumming circles

• Indoor and outdoor gardens

• Art at the bedside for patients and families

Remember, creative interventions are not just for patients and families.  Providing patient care, whether by nurses, physicians, PT, OT, counselors, social workers, patient transporters, dietary aides, housekeeping staff can be physically demanding, emotionally draining and sometimes thankless.  A creative healthcare organization takes care of not only patients, but also its professional and para-professional staff.

Have you ever wondered whether physicians believe in the healing properties of the creative process or even considered utilizing creative interventions  in their professional work?  A post written September 11, 2009,  

titled ‘Healing the Healer’  highlights one physician (Robert Climko, MD, MBA) who embraces and implements the creative process through the written word, also known as narrative medicine.  The use of Creative Interventions in healthcare applies not only to patient care, but also healthcare professionals.  In either case, engaging in the creative process epouses the Self-Care theory taught in nursing curriculums.

Here’s another physician who embraces and promotes creativity and arts activities.  A family practitioner based at University of California, Gabrella Miotto, MD, MPH discovered the healing benefits of engaging in the arts through personal experience.  In an article in a Family Medicine journal, Dr. Miotto states,

“What is clear is that healing is an inner process through which a person becomes whole, more individuated, though not necessarily cured, and that creative expression allows us to create meaning through our personal inner intuitive resources.”

With this newfound belief, Dr. Miotto and artist Laurie Zagon, introduced a therapeutic arts program for adult patients suffering from grief, anxiety or depression.  The arts program is called ’Bien Estar (Well-Being).  Wanting to share her belief that engaging in creative interventions with her colleagues, Dr. Miotto presented a workshop titled “Creativity and Healing: An Experiential Workshop,”  at the American Academy of Family Physicians Scientific Assembly and Wonca 2004 meeting.

By implementing creativity and the arts in healthcare systems, patients, families, staff, healthcare professionals and local communities all benefit by enhancing collaboration, harmony, compassion, tolerance, acceptance, empathy and self-care.  Below are a few creative interventions worth considering…

Artist-in-Residence program

Writing

Music

Dance

Humor

Laughing Clubs

Creative exhibits with work created by patients, families, staff and healthcare professionals

Drumming circles

Indoor and outdoor gardens

Art at the bedside for patients and families

 And now I leave you with this poem by one of my favorite poets…Rumi

Rules About Restraint

There is nourishment like bread

that feeds one part of your life

and nourishment like light for another.

There are many rules about restraint

with the former, but only one rule

for the latter, Never be satisfied.

Eat and drink the soul substance,

as a wick does with the oil it soaks

in. Give light to the company.

~Jelaluddin Rumi (1207-1273)

translated by Coleman Barks 

Note: email me if you want the bibliography

“Don’t ask what the world needs. Ask what makes you come alive, and go do it. Because what the world needs is people who have come alive.”  ~Howard Thurman

So what is a “Magnet Hospital?”  The term may conjure up energy fields around or within a hospital…a huge magnet attracting a hospital into its magnetic field…maybe it’s the hospital’s employees producing the energy field…perhaps it’s the quality of services hospitals offer to their local communities that causes the attraction.  Who or what is producing energy, and conversely, who or what is it attracting?

When hospitals publicize magnet status, it refers to their excellence in nursing services and are awarded the coveted magnet status by the American Nurses Credentialing Center (ANCC) through it’s ANCC Magnet Recognition Program® - the gold standard for nursing excellence.  The ANCC uses numerous criteria to thoroughly evaluate all areas of patient care.  It is a demanding credentialing process, and may take up to several years to implement and achieve.  Achieving magnet status is a BIG deal in the healthcare industry and nursing profession.  

Here’s  what Meryl Montgomery, MSN, RN, magnet program coordinator at Medical Center of Central Georgia in Macon, and incidentally a Magnet hospital, stated about magnet hospitals, “A magnet hospital is a whole different environment, because the nurses make different choices…they’re choices that lead to an environment of excellence.” (1)

Magnet awarded hospitals must demonstrate that their nursing services function beyond the level of excellence. Standards for magnet status are rigorous and include 14 dimensions, known as “Forces of Magnetism” that must be present for a facility to receive the prestigious magnet rating:

 • nursing leadership

organizational culture

• management style

• personnel policies and programs

• professional models of care

• quality of nursing care

• continuous quality improvement

• consultation and resources

• nurse autonomy

• community presence

• nurses as teachers

• the image of nursing

• interdisciplinary collaboration

• professional development

(Source: Lippincott’s nursingcenter.com. Nursing 2009. January 2009)

For those of you interested in learning the background of  ANCC, here’s a brief history…

ACNN was established in 1991 and is the world’s largest and most prestigious nurse credentialing organization, and a subsidiary of the American Nurses Association (ANA).  ANCC provides certification opportunities in more than 30 specialties and advanced practice areas of nursing.  It is the only national system for accreditation and approval of continuting education in nursing.

The Magnet Recognition Program for Excellence in Nursing was based on research completed by nurse researchers in the early 1980s who identified the attributes of organizations that were able to recruit and retain professional nurses.

Since then, the magnet program identifies excellence in the provision of nursing services, an environment that fosters and rewards quality nursing, recognizes the management philosophy and practice of nursing services and the adherence to standards for improving the quality of patient care.

As of October 2008, just under 5% of all U.S. healthcare organizations hold Magnet status. (2)  The 293 facilities with magnet status excel at 14 “Forces of Magnetism” (refer to the 14 dimensions listed above).  Hospitals with magnet status are shown to have shorter recovery times and higher patient satisfaction than other hospitals.  Achieving magnet designation not only benefits patients, but also nursing staff.  Nurses working at magnet organizations “consistently rated their employer higher than those working at non-magnet facilities, especially in the areas of :

• nurse satisfaction
• nurse presence on committees
• a culture supportive of nursing
• evidence-based changes in practice
• access to clinical reference tools

(Source: Nursing 2009 – download 

Magnet Organizations in Georgia

Being a curious person, I decided to find out what healthcare organizations in Georgia (my home state) had undertaken the rigors of achieving magnet status, and here they are…

Atlanta VA Medical Center,  Decatur GA.  Awarded in 2009

Medical Center of Central Georgia,  Macon GA.   Awarded in 2005

Saint Joseph’s Hospital of Atlanta.  Atlanta GA .  Awarded in 1995

St. Joseph’s/Candler – Candler Hospital.  Savannah GA.  Awarded in 2002

St. Joseph’s/Candler – St. Joseph’s Hospital.  Savannah GA .  Awarded in 2002

University Hospital.  Augusta GA .   Awarded in 2005

Now, if only these magnetic hospitals would incorporate creativity and the arts into it’s mission and philosophy to provide extraordinary patient care – that will add to their magnetism and they will truly come alive!

Is your local hospital a magnet hospital?  Find out at ANCC!

 Email me for the bibliography

Kentucky Center

Here’s an arts organization working to instill art into the healing process - Kentucky Performing Arts Center in Louisville.    In the fall of last year, Norton Hospital and James Graham Brown Cancer Center  in Louisville collaborated with Kentucky Center to have artists work at their healthcare facilites for a short-time with funding from the Humana Foundation.  The premise of the program was to provide diversional activities in the form of arts to patients, thereby helping them feel better.  Finally, a few more  businesses who ‘get it!” 

Robin Glazer of the Creative Center in New York knows first hand how creating art helps patients feel better and stated in the article, ” but not all health facilities are willing to invest in these kinds of arts programs.  This is a hard sell for a community that’s never heard of it before.”

However, there are many hospital systems with art and music programs, but what differs between the healthcare facilities in Louisville and the Creative Center and other arts in healthcare programs is,  education in a healthcare discipline.  For example,  Kentucky Performing Arts Center and the Creative Center uses local artists  in providing artistic services to patients.  In both organizations, the ”intent of the program is to provide opportunities for patients, their families, for staff to encounter the arts, to have an artistic experience, that we believe will enhance their healing process,” according to the Kentucky Center program director.  Other arts in healthcare programs are structured around the nursing, therapeutic and holistic  models where healthcare professionals are also artists, and may have undergone additional study and/or certification in arts in healthcare courses, and  integrate local artists into their programs.  The model and intent of creative programs will depend on the healthcare organization’s leaders.

Is additional study in this emerging and growing field necessary?  Not necessarily, but I think certification or additonal study will become a trend.  In healthcare, academic achievement in one’s profession is a driving force for many professionals in order to differentiate themselves and to excel in their field.  So, obtaining certifications in developing, facilitating and implementing creativity and the arts for patients and families is not surprising to me at all.

For upcoming posts, I will research whether there are any creative programs in healthcare organization in Georgia, and tell you my findings.  It should be interesting to see who does or doesn’t have creative programs, and whether they’re large, small, educational or innovative healthcare institutions.

The Lilly ‘Oncology On Canvas: Expressions of a Cancer Journey’ is a biennial art competition and exhibition that honors the journeys people face when confronted with a cancer diagnosis.  “The biennial competition invites individuals diagnosed with any type of cancer, their families, friends, caregivers and healthcare providers, to express, through art and narrative, the life-affirming changes that give their cancer journeys meaning.”

The program was started by Lilly USA, LLC  in 2004 in partnership with the National Coalition for Cancer Survivorship (NCCS).  Btw, Lilly is a global pharmeutical company started in 1876 by Eli Lilly, a pharmaceutical chemist and U.S. civil war veteran.  National Coalition for Cancer Survivorship (NCCS) is an advocacy group supporting quality cancer care for all Americans and empowers people with cancer to advocate for themselves.

Since it’s launch in 2004, Lilly Oncology On Canvas received more than 400 pieces of art from 23 countries.  Then in 2005, the artwork began it’s journey as  a traveling exhibit to more than 100 cities and seen by millions of people.  The 2006 competition received more than 2,000 pieces of art from 43 countries and journeyed close to 200 cities globally. 

And the journey continues…

Last year’s Lilly Oncology On Canvas competition was open to U.S. and Puerto Rico residents and received approximately 600 entries.  For 2008, the ’Oncology On Canvas’ competition awarded 26 prizes to 20 cancer charities selected by the 19 winners in various categories.

For the month of November 2009, artwork from ‘Oncology On Canvas’ will be shown at 55 different locations throughout the U.S. and Puerto Rico.

Below are the links to Lilly’s ‘Oncology On Canvas’ and the National Coalition for Cancer Survivorship (NCCS):

• Lilly ‘Oncology On Canvas’
• National Coalition for Cancer Survivorship (NCCS)

 As you look at the artwork created by individuals diagnosed with cancer, their families, friends, caregivers and healthcare providers, read their stories of why they felt compelled to create, be it paintings or photographs – it’s quite moving.  Below are a few quotes from Lilly’s ‘Oncology On Canvas’ website:

“While fighting her battle…she found she could express her feelings by painting.  The creative activity relieved her stress and anxiety.  She referred to the experience as mental and spiritual healing – not to be confused with a physical cure…She taught me by painting I could stay in spiritual contact with her.”  Look at the painting and read this mother’s story at Lilly Oncology On Canvas website.

“The American Cancer Society uses the symbol of the daffodil for it’s campaign to raise awareness and funding for cancer.  To give a daffodil is to give hope to the cancer patient, friend , family and caregiver.” See the painting and read this healthcare professional’s story at Lilly Oncology On Canvas website.

“My artwork is in comic strip form because I believe God uses Humor to help us heal.  Cartoons are fun…Fun is good.”  Look at the drawing and read this person’s story (she was diagnosed with cancer) at Lilly Oncology On Canvas website.

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Time and time again, whether it’s reading research articles or conducting Creativity Workshops for People With Cancer,  my belief that engaging in creative interventions reduces stress and anxiety levels is reinforced.  For example, in the first story above, the mother states her daughter’s experience with painting was ‘mental and spiritual healing-not to be confused with a physical cure.’  And there are thousands of stories like this…creative interventions is HEALing!

Andrew Weil, MD in his book ‘Spontaneous Healing,’  writes “The presence of cancer in the body, even in its earliest stages, already represents significant failure of the healing system (meaning the immune system).” (1)   He recommends patients work to improve health and resistance by “making changes on all levels: physical, mental/emotional and spiritual and to seek out HEALers.”

Remember, this being human is a multi-dimensional experience, and our experiences have physical – intellectual – spiritual – emotional components.  This is quite opposite the uni-dimensional approach prevalent in healthcare today.  Its akin to viewing us as unicellular organisms, like amobebas or parameciums rather than the complex, highly evolved, multi-dimensional, multicelluar beings capable of doing great things.

How do you want to be viewed by your healthcare team - as an Amoeba or Human Being?

 amoeba                            OR                         human being

Then, speak up for integrating Creative Interventions  in Healthcare!

Creativity Workshops for People with Cancer…

One to two times a year, I offer complimentary Creativity Workshops for people diagnosed with cancer and their families.  Btw, these are the Creativity Workshops I hope you will donate to.  At the conclusion of Creativity Workshops for People With Cancer, I conduct simple patient/customer satisfaction questionaires.  Below are several examples of paintings created by them at one of the workshops:

To read the stories of the persons who created the above paintings, click here to read the post on this blog.

Also, read ‘Quotes and Stories on Creativity By Patients and Healthcare Professionals’,  ‘The Science Supporting Creativity and the Arts in Healthcare’ under TOPICS in the left sidebar, and view additional paintings created by participants in other Creativity Workshops with People With Cancer & Their Families.

Actively engaging in creative interventions is HEALing.