Category Archives: health

Get ready to be awed…

Here’s a series of 4 videos by The New York Times about Antarctica. Watch the 4th video, ‘Under A Cracked Sky,’ and swim with seals, explore ice caves and float above the seabed crawling with life.

Creativity as a Strategy for the Nursing Shortage

 rumimusic-notes1ultimate_creativity_for_sitebob

 Creativity as a strategy for the nursing shortage – seriously?!

Before I explain the use of creativity as a strategy in addressing the nursing shortage, I want to share with you an interesting fact in the 2008 Gallup Survey for honesty and ethics among professions…

gallup

For the eighth consecutive year,  nursing is number #1 for most honest, ethical and most respected profession by the public.  But, I’m not at all surprised. Is there any question why? It certainly isn’t  the money or the hours, although these are important concerns.  In a very unformal survey,  nurses were asked why they became a nurse – the top answer was:

  • “I’ve always had the passion to care for others” = 57.6%
  • A nurse in my life inspired me = 17.5%
  • I wanted a job in healthcare, and nursing seemed to be a good fit = 16.7%
  • Nursing jobs are easy to find, and the pay is good = 5.0%
  • I’m wondering that too, and plan to leave the profession =3.2%        

              (Source: Advance for Nurses. Dec. 29, 2008, 10:27, p11)

Obviously, comfy work conditions, bankers’ hours and great pay are not the top reasons why nurses choose nursing – it’s the desire to make a difference in the world, and empathy for others –  what I consider to be a few key elements of social responsibility.

But, onto the nursing shortage…

In the previous post, I listed a number factors contributing to the critical nursing shortage.  Today, I decided to list a few strategies  involving creative interventions that may be helpful in addressing the nursing shortage, and here they are:

1. Implement Creativity [Arts] Programs for patients and families in inpatient settings, where the need for RNs is most critical.  However, arts programs should darlene2be implemented into every healthcare setting

First, In “The Science Supporting Creativity in Healthcare” located under TOPICS in the left sidebar, I include a study done by The Creative Center of patients’ satisfaction with the ‘art-at-the-bedside’ programs, and nurses’ response to the arts program. Here are the results again…

42.3% of the nursing staff believed the arts program affected their capacity to provide patient care. As you can see in the table below, the nursing staff felt the arts program enhanced their abilities to provide patient care

 Also, nurses’ job optimism and job satifaction increased with the implementation of the creativity program. This information can be useful as a tool in addressing nursing recruitment and retention efforts, and ultimately, the bottom line.

How Program Affected Ability to Provide Patient Care

Effect

N

% of those responding “Yes”

Happy to see patients’ enjoyment

20

38.5

Enhanced my ability to do my job

10

31.3

More optimistic about my job

7

22.6

Facilitated patient interaction

5

16.1

Increased job satisfaction

4

12.9

*Numbers add up to more than 100% because more than one response was permitted. Total number responding was 52.  Source:Final Report:Satisfaction and Outcomes Assessment. Hospital Artist-In-Residence Program of the Creative Center.

drumming2. Offer Creativity Workshops for nurses as a seminar, as a continuing education class for CEUs, as a short retreat.  Large and small businesses have corporate, management and staff retreats for team building purposes, idea generation and strategic planning.  A few workshop/seminar ideas can be drumming circles, painting classes, journaling, creativity theory class…the ideas are limitless.  By caring for professional caregivers (nurses, physicians, physical therapists, occupational therapists, nursing faculty professors, nurse assistants, etc), they will return to caring for patients refreshed, invigorated and more creative in their approach to patient care.

3. If the public identified Nursing as the most ethical, honest and respected professiodollarn in the U.S. – why are salaries lower than attorneys, unionized mechanics, tollbooth collectors, pharmacists, truck drivers, and nearly every other job category?  Do we value the work of mechanics, toll-workers and attorneys more than nurses?  Who are you going to call at 3:00am if you need help or are sick?  A nurse or an attorney?  Have nurses salaries reflect public opinion, including nursing academicians!  The single most important factor in choosing where nurses worked was salary/benefits -> 52.5% (Advance Nurse, Dec 29, 2008). 

4. Creativity Programs for nurses, creative interventions for patients & families – a strategry for nurse recruitment and retention.  With increased job satisfaction and optimism, nurses are much less likely to change healthcare companies.  According to an informal poll by Advance Nurse (Dec 29, 2008), “a good team of co-workers” was rated the highest as the strongest retention tool.  Below is the breakdown of the categories queried:

  • Good team of co-workers -> 59.6%
  • Feeling empowered -> 19.8%
  • Salary -> 15.2%
  • Benefits -> 5.4%

nurse-comradry

Nursing Shortage

 “Imagination is the beginning of creation.  You imagine what you desire, you will what you imagine, and at last you create what you will.”  ~bernard shaw

 

And what do I imagine?  The arts integrated in every healthcare organization.  Creative interventions incorporated into patient care… included in patient care plans…becoming a standard nursing order for patients and families…integrated into nursing theories…and so on…

bshaw

(an old book I transformed to a Book of Quotes)

As I was researching and thinking about the topic for this post, I realized the field of nursing is in a crises situation, thus, effecting the entire health care industry.  Nurses are the backbone in healthcare, providing the infrastructure, foundation, support, mortar, and represents a huge revenue portion in all healthcare organizations.  Nurses are firmly planted in insurance companies, public and private medical centers and hospitals, specialty outpatient centers, outpatient clinics, medical offices, schools, in the private and public sectors, and the list goes on.

The crises/shortage of nurses is reaching a critical point.  This chaos is necessary before change  within nursing and the entire health care industry, can occur.  Change in attitudes, perceptions  and value by the general public, by other health professionals, by health care administrators, by the business communities, by policy makers, and by nurses themselves. 

handsNurses enter nursing because they (we) are empathetic by nature,  are concerned for people’s well-being, and have a strong desire to help our fellow human-beings.  It would nearly be impossible for the health care industry to exist or function without nurses. 

But I’m digressing, so…

 

The Nursing Shortage

The information presented in this post on the current nursing shortage is not new.  In fact, the nursing shortage of RNs providing direct clinical care has been building for a number of years, and is due to a number of contributing factors.  A lot of this information was gleaned from the American Association of Colleges of Nursing website as well as other reputable websites.  Below is a summary of factors contributing to the nursing shortage and effects on patient care. 

Here’s some facts about the nursing shortage:

  • Enrollment in schools of nursing is not growing fast enough to meet the projected demand for nurses over the next ten years.  Extremely qualified students are being placed on waiting lists at nursing schools because of the limited number of available spots in academic programs.  In the mean time,students nurseconsider and pursue other career paths; they can’t put their professional lives on hold forever.  This cycle becomes a self-perpetuating crises.
  • In April 2006, Health Resources and Services Administration officials released projections that the nation’s nursing shortage would  grow to more  than one million nurses by the year 2020, and to meet the projected growth in demand for RN services, the U.S. must graduate approximately 90% more  nurses from US nursing schools.
  •  A shortage of nursing school faculty is restricting nursing morning-glory2program enrollments.   In 2007, U.S. schools of nursing turned away 41,285 qualified applicants from baccalaureate and graduate nursing programs due to insufficient number of faculty.  Unfilled faculty positions, resignations, projected retirements, and the shortage of students being prepared for faculty positions pose a threat to the nursing education workforce over the next five years.
  •  With fewer new nurses entering the profession, the average age of the RN is  climbing.   In February 2007, The Federal Division of Nursing released the average age of RNs in March 2004 was 46.8 yrs; in 2000, the average RN age was 45.2.  The RN population under the age of 30 dropped from 9.0% of the nursing population in 2000 to 8.0% in 2004.
  • The total population of registered nurses is growing at a slow rate.    The RN shortage is 8 percent now and is projected to be 46 percent by 2020 if nothing is done to expand the capacity of nursing schools (Joint Commission on the Accreditation of Healthcare Organizations, JCAHO).

nurse1

  • 78 million Baby Boomers are going to put unprecedented demand on the healthcare system with the 65 and older population growing by 54 percent between 2000 and 2020 ( U.S. Department of Commerce, Census Bureau). A serious shortage of nurses is expected and the future demand for nurses is expected to increase dramatically as the baby boomers reach their 60s and beyond. Many of these Baby Boomers are experienced nursing professionals who have taken on administration and education roles. However, they too will be retiring and there is no one to replace them.
  • Insufficient staffing increase stress levels, impacts job satisfaction, and as a result, many nurses are forced to leave the profession.  Dr. Peter Buerhaus reports that greater than 75% of RNs believe the nursing shortage directly effects the quality of their work, the quality of patient care, and the amount of time nurses can spend with patients.  Almost all surveyed nurses see the shortage in the future as a catalyst for increasing stress on nurses (98%), lowering patient care quality (93%) and causing nurses to leave the profession (93%).  March-April 2005 Nursing Economics.
  • According to another study by JAMA (Journal of the Americanno-admittance Medical Association, Oct 2002), nurses reported greater job dissatisfaction and emotional exhaustion when they were responsible for more patients than they could safely care for.
  • High nurse turnover and vacancy rates are affecting access to health care.   In March 2005, the Bernard Hodes Group released the results of a national poll of 138 health care recruiters and found that the average RN turnover rate was 13.9%, the vacancy rate was 16.1% and the average RN cost-per-hire was $2,821.

 Below is graph on the current and future status of the nursing shortage in the US.  As you can see, the demand for RNs will contiue to far exceed the supply of RNs.  Evidently, something needs to change or health care will be in a more dire situation.

nursing-shortage

cw_hope-lodge-portrait5music-notes1paintpalette1morning-glory2

 Creativity Interventions as a strategy to address the nursing shortage – in the next post 🙂

 

Arts in Health Care Program at Shand Medical Center, FL…

lighted-trees

A number of years ago when I first read about integrating the art in healthcare, I read the story how the arts program at Shand Hospital, University of Florida, got started.

Now, there are a number of comprehensive art programs throughout the US, but the AIM Program at Shand Hospital is one of the first I read about and piqued my interest in incorporating creativity into patient care.

The Arts in Medicine (AIM) Program at Shand Hospital started with a dream by a nurse-visual artist, Mary Rockwood Lane, and physician-poet,  John Graham-Pole.  For Mary, the desire to incorporate art-making directly into patient care stems from her personal experience of healing through engaging in the creative process – painting in her case.  She states in one of her articles, “The creative process transformed my life. It was not a 1-hour-per-week visit to a health provider.”  In her case, it was engaging in the creative process that helped her heal, and is the primary topic and purpose of this blog.  Because she is a nurse, she felt compelled to bring the healing power of art to others, i.e, patients.  I, too, am compelled and driven to do the same – to bring the creative process directly to patients, families and healthcare staff.  The physician, John Graham-Pole, had the vision of artists working with students at the medical school. 

Focus now on present day…Shand’s AIM has visual artist-in-residence, musician-in-residence, dancer-in-residence, story teller-in-residence, and a theatre troupe-in-residence.  AIM has become part of the hospital’s infrastructure and mission.  The artists-in-residence work in a variety of units: the BMT unit, pediatric intensive care, diabetic adolescent unit, psychiatry, autistic  children, general oncology, medicine, gynecology, surgery, and mother-baby.

AIM at Shand’s Hospital is a shared vision between artists and nurses..the program is deeply integrated to nursing care, and the nurses are key participants in the program.  Nurses and physicians write prescriptions for creative interventions (art) just like writing a prescription for another treatment, activity or medication.  According to Mary Rockwood Lane, “the art is part of the nurse’s healing modalities in meeting patient outcomes.”  Nurses are the catalysts to help patients and families embrace creative expression in health care settings, and needs to incorporate creative interventions into patient/family care.

To learn more about the Arts in Medicine Program at Shand Hospital, do an internet search…there’s alot of information out there.

Here are excerpts from articles written by Mary Rockwood Lane, RN, PhD:

“…the hospital feels more sensitive, more caring, as a result of this art.”

“The creative process transformed my life…because I was a nurse, I felt compelled to bring the healing power of art to others, to initiate a new program, and to seek out professional allies and build clinically based liaisons.  I believed that, as a nurse, I could reach out and help others.”

“Creative Interventions have been shown to shorten hospital stays and decrease the use of pain medication dramatically.”

“Performances of music, dance, poetry, and theater are put on in the hospital lobby.  Patients are brought from their rooms, and families and staff stop; the music draws people toward its transformational power.  Patients, family, and staff alike leave relaxed and uplifted; they are changed and healed.”

“Patients who are visited by the AIM artists say their whole experience of being ill is changed forever.  They are more hopeful, happier, feel better, and have less pain.  This is true even if the patients do not engage in creative activities themselves but just watch the artists.”

Here are excerpts from an article written by John Graham-Pole, MD:

“The past decade has confirmed my belief that art plays a central role in serving the sick and the overtly healthy among us.  This marriage – the unifying of art and science in medicine – is a present and much needed reality.  It offers a lasting antidote to the epidemic dis-ease of body, mind and spirit…it is no accident we use the word art to describe both the creating of works of beautiful form and the providing of skilled compassionate care.  Art ta[s, for each of us, whatever our circumstances, a deep well of physical, emotional, and spiritual well-being.  It is indispensable to our lives, and to our total health.  Where more apt to invest in it and ensure its flowering than in our nation’s hospitals?”

Although both health care profesionals cited above have written many articles, the excepts are from 2 articles…email me if you’d like the references. Read again the “Science Supporting Creativity in Healthcare” located under Topics in the left sidebar of this blog.

And now…

robert-fritz

“If you limit your choices to what seems possible or reasonable, you disconnect yourself from what you truly want, and all that is left is a compromise.” ~robert fritz

Happy Holidays!

Here in The States, this week is a celebration of Christmas, Hanukkah, Kwanzaa, and all other similar holidays celebrated throughout the world.  Happy holidays to you all!

yellowstone-buffalo

                                        (Winter, of course!, in Yellowstone Park)

When I look at this picture, my eyes are soothed, my mind and spirit quieted and rested, and my body relaxed.  Nature is the ultimate, most unique of healers.

  

peace_one_day_logo