Tag Archives: nursing

In Defense of Writing…

This post is written by a graduate in English literature turned nurse – Sashana Macatangay.  She is enrolled in the Master’s in Nursing program at Azusa Pacific University.  Sashana believes the act of writing helps with clarity of thought, sharpens critical thinking and observational skills, and last but not least, that the humanities should be incorporated into nursing curriculums.  And why you may ask?  This is Sashana’s story and explanation…

Florence Nightingale, the most celebrated pioneer of the nursing profession, once likened nursing to an art. From Nightingale’s perspective, nursing was, in nightingale-creativityinhealthcarefact, “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 writing-creativityinhealthcaredefending 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.

What’s a ‘Magnet’ hospital?


“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

Celebrating International Nurses Day – May 12, 2009

Every year, May 6 begins National Nurse’s Week in the US, and ends May 12, designated and recognized as International Nurses Day and the birthday of Florence Nightingale, the founder of modern nursing.

“For me, nurses are the unsung heroines and heros of the health profession.” ~John Sentamu, Bishop of Westminster Abbey

peopleglobeGlobally, May 12 is designated as International Nurses Day (IND) by the International Council of Nurses.

In the US, May 6 – May 12 is National Nurse’s Week.  The theme for this year is “Nursing: Building a Healthy America.”  The week was established to recognize and honor nurses who meet the health and mental health care needs of the  nation, and for the quality work they provide seven days a week, 365 days a year.  Also, nnw09National Nurses Week focuses on highlighting the diverse ways in which nurses are working to improve health care. From bedside nursing in hospitals and long-term care facilities to research institutions, state and national governments, the nursing profession is meeting the ever expanding health care needs of society. The 1st National Nurse’s Week was observed from October 11-16, 1954. The year marked the 100th anniversary of Florence Nightingale’s mission to Crimea. In 1994, the American Nurses Association’s Board of Directors designated May 6 – 12 as the official dates to observe National Nurses Week, and established them for all subsequent years. 

Facts, quotes & comments about nursing and nurses…

  • According to Kirsten Stallknecht, president of the International world_mapCouncil of Nurses (ICN), there are more than 11 million nurses worldwide providing care in hospitals and rural health centres, schools, workplaces, homes, prisons, war zones and refugee camps.
  • There are nearly 2.9 million registered nurses in the United States, and 2.4 million of them are actively employed.
  • “It’s hard to live with a nurse because… unless you are bleeding profusely, with bones protruding from the skin, and you can’t breathe, you won’t get any medical attention or sympathy.”  ~every nurse’s significant other
  • “I am fond of nurses.  They treated me well.  They help people.” ~9 year old schoolgirl, Botswanahands
  • The International Council of Nurses (ICN) is a federation of 133 national nurses’ associations representing the millions of nurses worldwide. Operated by nurses for nurses since 1899, ICN is the international voice of nursing and works to ensure quality care for all, sound health policies globally, and the advancement of nursing knowledge.
  • According to projections released in 2006 from the US Bureau of Labor Statistics (BLS), growth rate for RNs will exceed 21% from 2006 to 2016.
  • “Nurses are committed to caring for all persons nursesacross the life cycle: pregnant women, infants, children, adolescents, adults, and the elderly. They are also there for the most vulnerable groups, such as the poor, refugees and displaced persons, street children, and the homeless…it is this element of humanity and caring that sets nurses apart.” Kirsten Stallknecht, president of the International Council of Nurses (ICN).
  • “My discovery, as a patient on the medical service and later in surgery, is that the institution is held together, glued together, enabled to function as an organism, by the nurses and by nobody else.” ~Lewis Thomas, MD in ‘The Youngest Science’
  • “Nurses have been pivotal to my own recovery and health.  I supermanknow this is also true for millions around the world who are restored to health and comforted in illness by the caring, compassion and expertise of nurses.” ~Christopher Reeve, actor and director
  • In the US, nurses were ranked first for 8 consecutive years for their honesty and integrity, with 85% of Americans rating them “high” or “very high,” according to the 2008 Gallup Poll.gallup
  • In every region of the world, the public consistently rates nurses and nursing as the ‘most admired profession’. Polls taken in Australia, the US , the UK and other countries and regions indicate that up to 90% of the public ranks nurses #1 over all professions. (ICN, Geneva, Switzerland, May 12, 2000)
  • “I know that nurses will continue to be there when it is needed – when people suffer and the vulnerable need care and assistance.” ~Dr. Gro Harlem Brundtland, Director General, WHO
  • 24/365  = the hours in the day and days in the year that nursing care is ‘there for you’
  • A Pittsburgh based medical apparel company, on+qor, has produced a music video in tribute to the nursing profession. The video can be seen on http://www.onqor.com/nurses/.  

 And the most famous nurse…Florence Nightingale




In celebration of International Nurses Day…

NURSES Fingerprint Portrait

To see a much larger image, read the ‘fingerprinting’ and for prints, click here

MHand_nurses fingerprint_blue sm

(the fingerprint is mine)

Thank every nurse in your life!

New York Nurses Score Huge Victory Against Large Hospitals

Although the main purpose of this blog promotes integrating creativity and the arts in healthcare, this blog also promotes nurses and the nursing profession, an integral and valuable profession in the healthcare industry.
Here’s some very distrubing news about illegal maneuverings by a healthcare network in northern New York against nurses.  Northeast Health, a network of hospitals which includes Albany Memorial and Samaritan Hospitals settled a class-action lawsuit alleging hospitals in upstate New York had for years violated federal antitrust law by sharing confidential wage data and conspiring to depress wages for registered nurses. Nurses hailed the settlement as an important step towards ensuring fair compensation for their profession and helping to solve the nurse shortage crisis, thereby improving quality of care for patients.

Northeast Health of Troy, N.Y., agreed to pay $1.25 million in a settlement that was filed on March 9, 2009 in U.S. District Court in the Northern District of New York.   The settlement is subject to court approval and includes provisions to halt anti-competitive behavior by Northeast Health in the future. These provisions prohibit Northeast justiceHealth from sharing current and future nurse wage information with other healthcare facilities in the Albany area, and give plaintiffs access to Northeast Health witnesses in order to further prosecute the action against other area defendants.  Northeast Health is the first among Albany area hospitals to “settle out” of the lawsuit and similar suits are moving forward in Detroit, Chicago, San Antonio and Memphis.  The company did not admit any wrongdoing and called the allegations in the lawsuit “completely false and offensive. (They’re not going to admit to exploitation and greed!)  About 2,500 nurses are represented in the class.

“We never conspired with any other hospital to suppress nurse wages, nor did we ever violate the antitrust laws in any manner,” the hospital network said in a statement.

“This is a breakthrough not only for nurses, but for the people we care for every day. For too long, hospitals cut corners when it came to valuing the hard work of nurses. Our hope is that this is the first step towards making exploitation1sure that hospitals invest in the kind of quality care that patients deserve,” said Cathy Glasson, RN, of the Nurse Alliance of SEIU.  “By helping to ensure competitive methods for setting RN wages, we can attract more new nurses to the profession, bring non-practicing nurses back to the bedside, and improve patient outcomes,” said Anne Jacobs-Moultrie, RN.

The suit, brought by two Albany, N.Y., nurses, is one of five related suits filed in 2006, in which nurses alleged that hospitals agreed to enter into a conspiracy to keep nurse wages artifically low and did so by sharing compensation information such as wage surveys. The SEIU Nurse Alliance has played a leading role in supporting empirical research that has exposed the national problem of employer collusion around nurse wages, shown the link between wage levels and the shortage of bedside nurses, and demonstrated the importance of staffing levels for improving patient care.

Heidi Hartmann, president and labor economist at the Institute for Women’s Policy Research, said the settlement was significant and could have a spillover effect on the related cases. One company’s settling could set a precedent for the other defendants, she said.  There are  four related suits across the country. 

Below are links to the press coverage in various newspapers:

First of all, I was shocked and dismayed to read about the illegal activities in artificially depressing RN wages and salaries by the New York hospitals.  In so greedydoing, the hospital management team not only contributed to the growing nursing shortage, but also put patient lives at risk (!).  I wonder if any of the hospital management team had any family member(s) in hospitals in northern New York? Most likely not, because low nurse-patient staffing ratios  are directly linked to the quality of patient care.  Northeast Health joined their brethren on Wall Street where greed, fear, short-sightedness and taking advantage are the main goals.  ‘Taking advantage’ is defined in the dictionary as “to profit selfishly by exploitation.”

I realize many hospitals are non-profit and many function in the red due to a number of uncontrollable factors in the healthcare system, such as pre-existing condition policies by insurance companies…use of emergency departments as primary care visits…treating the indigent…close to 46 million Americans uninsured (or 18% of population under 65 years)…the underinsured…denial of reimbursement by insurance companies…unhealthy health conditions of  US people…escalating senior population due to aging baby boomers…increasing number of chronic health conditions…living longer…

However, there is no excuse for ‘taking advantage’, of nurses who’s main goal is helping people.

Here’s a quote that’s very applicable to the above news article…

 “You must not loose faith in humanity.  Humanity is an ocean; if a few drops of the ocean are dirty, the ocean does not become dirty.” ~ gandhi


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

Nurses are the backbone in healthcare, providing the infrastructure, foundation, support, and mortar in all healthcare organizations.  Without nurses, there would be no health services, no healthcare organizations and no healthcare dollars fueling the largest industry in the economy.  Nurses are firmly planted in insurance companies, public and private medical centers and hospitals, specialty outpatient centers, outpatient clinics, medical offices, schools, the legal system, public policy and long-term care industries, to name a few.  In fact, if you are observant, you will notice nurses working in every industrial sector, both great and small, of the economy.

And justice for all…


The story of 2 paintings…

This week’s post deviates from the usual focus of this blog of the need for  integrating creativity and the arts in healthcare.  Instead, I write about 2 paintings created in 2004 titled, “Steely Resolve 1” and “Steely Resolve 2.”  This is their story…

A friend of mine, Donna, was diagnosed with breast cancer in 2002 and had gone through the usual course of chemotherapy and radiation treatments.  When we met again during the spring of 2004, we updated each other on life…she about her cancer treatments and family, and I on the new paintings I was working on – the synergy series.  At the time, she was experiencing new pain in her hip and lower back, and was scheduled for an MRI (magnetic resonance imaging). 

Donna wanted to know more about the new synergy series which captures the synergy existing between the sciences, nature, illness and disease, and human and universal spirits.  In short, I ended up with her chest x-rays with her saying, “maybe you can use these in your art.”  Btw, the x-rays were taken months after she had completed chemotherapy and radiation.

I looked at the x-rays and laid them down.  As an artist, I have to let the creative process unfold and percolate, which means it may take a few hours, a few days or a few months to several years. As a nurse, I didn’t like what I was seeing on the x-rays.  A few days later, looking again at the chest x-rays, a medical report fell out of the large envelope.  While reading it, I was so overwhelmed with the gravity of my friend’s situation, diagnosis, prognosis, and her age.  From that moment, I knew how I would utilize the x-ray images.  mhand_steely-resolve-1-and-taxol-sm

What evolved is the painting titled “Steely Resolve 1” 

What do YOU experience when you look at the painting? 

The chest (thoracic) is the image taken from my friend’s x-rays.  The circular images represent Taxol, a drug used to treat breast cancer.  The vertebraes are painted silver for the color of steel. And the dark area in the verterbrae is where the cancer had spread and therefore, the pain in her lower back.

The most important thing I wanted to convey was hope, thus the colors of the rainbow for the background and outlining the body – universal hope and the fighting human spirit. 

After completing the painting, several people commented that all they saw was a big question mark.  This never occurred to me during the entire painting process, i.e., I never saw the question mark. I did not want my friend’s life to be in question or a question mark.  So, I immediately began another painting – of her healed.  The title of the 2nd painting is ‘Steely Resolve 2.’


                                                (Steely Resolve 2, 2004, Marti Hand)

Note: To see larger images of the paintings, go to www.martihand.com and click ‘synergy series.’

For decades, the scientific and medical communities have focused on discovering a cure for cancer – without success.   It’s time to try or include something new to the treatment plan – offer creative interventions to patients and families!   Put care into the equation – caring for the whole person, i.e., body-mind-spirit-emotion with creative interventions. 

“When you’re treating advanced breast cancer, you’re not looking for a cure, you’re looking for stability and quality of life.” (Patient being treated at Vassar’s Dyson Center for Cancer, Poughkeepsie Journal)


For Donna…



Drumming to WELLNESS

I was browsing through some old pictures a few days ago,  and came upon photosdrumming1 of a drumming circle I had at my home a few years ago, and decided to use drumming as the topic for this post.

In the picture to the right, is my friend Judy Chiger, teaching and leading us (all women) in musical expression with drums.  Judy is a physician, holistic practitioner, and promotes drumming as a mechanism for stress reduction, health promotion, spiritual connection, healing,  and fun – something we all need more of.  The drums she uses are Health Rhythms.

Drumming Circles

Drum or drumming circles are not new…they’re probably one of the oldest forms of community and team building known.  Drumming is becoming a cultural phenomenom, and the media is beginning to report on the proliferation of group drumming and its application for health and wellness. 

Drumming circles essentailly provides a portal into musical and creative expression, making it an easy and accessible experience for anyone at any age or ability.  Most people participating in drumming circles are most often not professional musicians.


(drumming circle and blowing bubbles at night, 2006)

Drumming circles are happening in many, many places. People attend these events not to become better percussionists, but to reduce stress, build commUNITY, and have fun. It is an expressive and musical activity that engages the mind, body, spirit, and emotions.  Arthur Hull, father of the modern day drum circle, developed his unique approach to facilitating drum circles in the 1980s through an observation of the nmusic-notes1eed that extended beyond percussion skill development. According to Arthur, “when we drum together, it changes our relationships and helps us cope with whatever challenges life hands us.”

Other healing and transforming effects can occur when people join together in drumming. Those who’ve been depressed can recover their overall will to live through this kind of celebration.


Benefits of Drumming

Music can also allay stress. In one recent study, neurologist Barry Bittman of the Mind-Body Wellness Center in Meadville, Pennsylvania, drumsgathered a group of 10 people and had them beat hand drums for an hour while a music “facilitator” conducted. Afterward, Bittman took blood samples. The drummers, he found, had heightened levels of immune cells called natural killer cells that seek out and destroy both cancer cells and cells infected by viruses. A control group that read in silence experienced no such upsurge.

Bittman believes that group drumming, through its camaraderie, support, exercise, and music making, signals the brain to lower the production of cortisol, a stress hormone secreted by the adrenal glands. Less cortisol has been associated with a heightened immune response and may help the body fight off infection. “I’m not saying I have a cure for cancer,” Bittman cautions. “But what I am saying is that we have a very important step in understanding a delightful, enjoyable, and fun way for people to reverse the stress response in a manner that leads us to positive biological changes.”  (Discover Magazine. By Josie Glausiusz,  August 2001)


(drum circle held in hospital education center, UK)

African and Asian cultures have been practicing community percussion for thousands of years. Now Americans are fast joining “drum circles,” informally or through organized centers, to reduce stress, connect with others or just jam. A recent study in the journal, Alternative Therapies, even found an increase in disease-fighting cells among participants in drum circles. (Time.com.  Drumming Circles By Harriet Barovick.  Monday, May 7, 2001)drum-healthrhythms

Drumming in Healthcare

Drumming can be incoporated into all types of healthcare settings for music making, such as inpatient hospitals, outpatient facilities, VA hospital systems, cancer centers, children’s hospitals, support groups, women’s centers and medical practices.  Patients, families and healthcare staff can drum their way to:

  • personal health
  • social well-being
  • combat social isolation and lonliness
  • reduce stress, anxiety, depression
  • boost their immune system
  • enhance overall well-being

Other areas worth exploring are corporations for teambuilding and local recreational centers for commUNITY building.


And now, I leave you with this thought…

Medical treatment is fully effective only when the whole person is being treated – body, mind, spirit, emotion.

Creativity as a Strategy for the Nursing Shortage


 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…


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



% of those responding “Yes”

Happy to see patients’ enjoyment



Enhanced my ability to do my job



More optimistic about my job



Facilitated patient interaction



Increased job satisfaction



*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%


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…


(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).


  • 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.



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


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


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…


“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

Rheumatoid Arthritis (RA), Pierre Auguste Renoir and art-making…

renoir_-_luncheon_at_the_boating_party1  (Renoir’s Luncheon of the Boating Party, 1881)

Just the other day, I attended a conference on evaluating disease in patients with rheumatoid arthritis at Emory University Hospital in Atlanta.  The lecturer was a rheumatologist from the Hospital for Special Surgery in NY.  The main points that ‘stuck’ with me were the following:

  • the importance of a multi-dimensional health assessment completed by the patient identifying level of physical functioning and pain levels
  • the need to gather evidence-based outcomes of medical treatment
  • treating the whole patient, not just the disease

Also, there is a link between premature death of patients with rheumatoid artritis (RA) and social deprivation (1).  This may be related to a number reasons such as delay in seeking medical attention; vulnerability for the disease to get worse due to other medical problems; different medical treatment and mangement by physicians; not following the medical treatment plan by the patient.   Social deprivation has been also linked to ongoing depression which affesuzannects 13-20% of RA patients (2).  Depression in RA patients is associated with pain, disability from work, poor adherence to treatment and sometimes suicide (3).

To focus on patient-centered outcomes, clinicans are encouraging patients to attend self-care programs and local support groups.  Self-care management programs’ goal is to control the disease (RA) from getting worse by managing the pain, damage and disability of RA, but also to provide psychological, educational and employment opportunities (4).                                                                                                      (1st time painter)

Patients with rheumatic conditions that participate in support groups seem to experience a decrease in feelings of loneliness, achieve new relationships, improve skills in eliciting and accepting social support, have better daily functioning, and may have an increase in life satisfaction outcomes (5).  There are other avenues of support that can accomplish similar goals. The process of creating art has been proposed to enhance cognitive abilities, increase self awareness, help cope with symptoms of a physical disorder, and gain relief from emotional distress such as anger, loss, depression, worry and anxiety in certain chronic conditions (5,6). 

I want to re-emphasize that creative interventions are not only benefical for patients diagnosed with rheumatoid arthritis, but cancer and chronic disease management, disease prevention – art, dance and musical interventions can be helpful when treating brain injury, dementia, cardiovascular accidents, depression, beareavement, pain management, peds, sexual abuse, and AIDS (7).

Note:  I did not do the periodic research on rheumatoid arthritis above; a rheumatologist  (Dr. Ines Colmegna) working at Emory did.  However, if you want the bibliography, email me at marti@martihand.com.

Pierre Auguste Renoir

The famous French painter Renoir, whose works adorn many museums, suffered from debilitating rheumatoid arthritis during the last three decades of his life. He suffered his first attack in 1898, and his joints became severely deformed later.

In 1904, Renoir weighed only 105 pounds and was barely able to sit. By 1910 he could not even walk using crutches and he became a prisoner in his own wheelchair.   His hands were completely deformed, like the claws of a bird.  A gauze bandage was used to prevent his fingernails from growing into the flesh. Renoir was unable to pick up a paintbrush at this point and it had to be wedged between his fingers.  Still, he continued to paint everyday and produced some of his greatest masterpieces.

Painting was almost a physical need and sometimes a cure, as if Renoir wanted to create on the canvas those things which he had to miss in real life because of his disability. Even when he woke at night crying in pain, he asked for some painting material and started to make small paintings on wood – see below.