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New international analysis of nurses’ wages shows salary stagnation and fall in purchasing power

The International Centre on Nurse Migration (ICNM) today released an analysis of pay data collected by the International Council of Nurses (ICN) International and Asian Workforce Forums over 10 years (2006-2016). The findings show that many nurses around the world have experienced a real terms’ fall in their purchasing power over the past 10 years. In Asia, there is also evidence of stagnation and a decline in pay in the last two years.
The recent UN Commission on Health Employment and Economic Growth made the case for investment in health services as a pre-requisite for economic prosperity rather than a drag on growth and identified the scale of the needs-based shortage for nurses worldwide. Given the relative fall in nurses’ purchasing power over the last 10 years, there is an urgent need to give the world’s nurses a pay rise and improve working conditions in order to address the attractiveness of the profession.
“While there are limitations to the data that ICN has collected which should be considered in the interpretation of the results, the findings clearly show significant periods of minimal pay growth across the world,” said Howard Catton, ICN Director of Nursing and Health Policy and report author. “With a predicted shortage of nine million nurses by 2030, and global health priorities such as Universal Health Coverage and NCDs it is vital for governments to invest in nursing and address issues to recruit and retain nurses, such as starting salaries and prospects of reasonable career and pay progression.”
The timeline coincides with the beginning of the global economic crisis in 2007/2008 and has continued until 2014. Whilst there is evidence of a pick-up in pay in the last two years in some countries, this appears to be driven by a limited number of countries, rather than being a trend across the board. Over the same period, turnover rates appear to have increased, due to the ageing nursing workforce, but also to heavy workloads, low compensation and poor working conditions which are driving nurses to leave the profession. These trends are set against the backdrop of a global shortage of nurses and the recent UN Commission estimating that this equates to approximately nine million nurses.
Catton continued that “Despite the current and predicted shortage, it appears that pay is not being used as a lever to improve either the recruitment or retention of nurses All governments have a responsibility to ensure the safety and security of their citizens and this includes having a sufficient number of healthcare professionals, because the consequences of not are detrimental to human health and mortality.”
The data was collected through the ICN annual Workforce Forums which bring together representatives from national nursing associations (NNAs) to probe and debate nursing workforce issues and working conditions. The Forums aim to stimulate thinking and enhances learning to ultimately develop proactive strategies. The NNAs that have attended the Asia or International Forums include ICN members from Canada, Denmark, Hong Kong, Indonesia, Ireland, Japan, Korea, Macau, Malaysia, New Zealand, Philippines, Singapore, Sweden, Taiwan, Thailand, and the USA. In total, the Forums cover a population of approximately nine million nurses.
The recent launch of the Nursing Now global campaign provides a generational opportunity to raise awareness of the value and contribution of nurses and to make the case for positive political choices and investment. This should include significant improvements in nurses’ pay and working conditions around the world.
ICN is also delighted to announce that Professor James Buchan, an internationally renowned global expert on the nursing workforce and health sector human resources, who reviewed the development of this report, will be [working in an advisory capacity with ICN to provide advice and support in relation to workforce and health policy. Additionally, Professor Buchan serves as a Strategic Advisory Group member of the International Centre on Nurse Migration (ICNM).

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What are your thoughts on violence in nursing? Oklahoma Baptist University College of Nursing

In nursing education my goal is to educate students in the undergrad setting how to handle that and make sure it’s not welcome.

Megan Smith, MSN, RN, CPN, CNE.

I think it’s more of a problem than our society recognizes. The truth is it happens in all units of health care. Dawn Westbrook, MSN, RN, CNE.

Sometimes nurses just accept it as part of the rule. I think there needs to be more consequences. Joan Klerekoper, MSN, RN.

It’s unfortunate we have to deal with bullying and violence. We need to be intolerant of it. Dr. Lepaine Sharp-McHenry, MSN, RN.

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Is there any way to strongly encourage someone to get therapy for childhood trauma that has never been processed? My friend has shared the trauma with me but says she has dealt with it and does not want to talk to a therapist. —Teresa
(This is a continuation from last weeks column)

 

Many times, trauma survivors re-live childhood experiences with an unresponsive or abusive partner. They re-live it because it is familiar to them, they are attracted on an emotional level to a partner who facilitates the re-enactment of previous dysfunctional relationships. For example:
Donna and Ricky came to therapy because Ricky was at a loss in knowing how to deal with Donna when she became emotional. This was Donna’s third marriage and Ricky’s second. When the couple argued, Ricky said he felt like Donna was provoking him to hit her. “I have never hit a woman and don’t plan to start now.” Donna said she really didn’t want Ricky to hit her but her previous husbands would hit, slap and push her when they argued, so physical aggression was “normal” for her.
Donna also shared that her childhood home contained domestic violence and her father would beat her mother when he was drinking. Countless times she witnessed this violence. AND countless times she said she would never marry a man like her father.
Unfortunately Donna never got involved in therapy to understand the traumatic impact that domestic violence had in her childhood. She actually chose a man who was not a batterer, a healthier, kinder man for her third husband but lacked the thoughts, emotions and behaviors to let him love her in a healthy way. She still had her trauma script playing and was indeed trying to provoke him to hit her.
It is important to recognize unhealed trauma as a dynamic force in an intimate relationship. It can super-charge emotions, escalate issues, and make it seem impossible to communicate effectively. Issues can become complicated by:
*Heightened reactions to common relationship issues.
*Emotionally fueled disagreements
*Withdrawal or distant, unresponsive behavior
*Lingering doubt about a partner’s love and faithfulness
*Difficulty accepting love, despite repeated reassurance
In a relationship, a history of trauma is not simply one person’s problem to solve. Anything that affects one partner impacts the other and their relationship. Trauma-informed therapy works by helping couples begin to see how they experienced traumatic abuse or neglect, and how it still affects them, and impacts their current relationships. The goal is to help each partner learn to understand each other’s story, how it impacts their relationship, and how to process thoughts and emotions in healthier ways.

Vicki L Mayfield, M.Ed., R.N., LMFT Marriage and Family Therapy Oklahoma City

If you would like to send a question to Vicki, email us at news@okcnursingtimes.com

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Oklahoma Medical Research Foundation President Stephen Prescott, M.D.

Although you may associate them with childhood, vaccines remain important at any age.
“Vaccinations are an important part of staying healthy for all adults,” said Oklahoma Medical Research Foundation President Stephen Prescott, M.D.
For starters, he said, make a point of getting the annual flu shot. It’s an every-year necessity, as the virus mutates constantly.
“The flu shot is one that we know we should get, but that doesn’t mean we all get it,” said Prescott. “It’s not perfect, but it is your single best defense against the flu.”
The combined vaccine for tetanus, diphtheria and pertussis (known as whooping cough) should also be on your checklist, said Prescott. All adults should receive this vaccine—known as DTaP or TDaP—if they didn’t as children, and then a tetanus and diphtheria booster every 10 years after.
Since the introduction of the vaccine, cases of tetanus and diphtheria have dropped by 99 percent, and whooping cough has been reduced by 80 percent. But those numbers are expected to climb.
“I really encourage this for protection from all three, but pertussis in particular has had a large resurgence in adults because of the waning in immunization for children,” said Prescott.
Two more key vaccines come along once you’re a little longer in the tooth.
The FDA recently lowered the vaccination age for shingles to 50, and doctors say the new shingles vaccine, Shingrix, is a must. It’s also recommended that you get the new vaccine even if you’ve previously received the first shingles vaccine, Zostavax.
“If you have ever had chicken pox, the shingles virus is already in your body, and as you get older your immune system becomes less equipped to keep it at bay,” said Prescott. “This new vaccine is superior and everyone should get it as soon as they are eligible. The risk rises with age, so get it as soon as you can to be safe.”
Another must-have for adults age 65 and up is the pneumococcal vaccine. The CDC also recommends the vaccine for children younger than 2, but it’s important to receive it again later in life.
Pneumococcal symptoms can range from ear and sinuses infections to pneumonia and bloodstream infections. It can even be fatal. There are two primary vaccines for pneumococcus, PCV13 and PPSV23, that you should receive about one year apart.
Other vaccines are a little more specialized and the need for them depends on your lifestyle, travel habits, health condition or other factors. These include yellow fever, hepatitis A and B, and HPV. If you never received the MMR vaccine—measles, mumps and rubella—you should also consider getting one now because the number of cases is on the rise as fewer people immunize their children.
“You should ask your doctor for advice on which additional ones you need for your circumstances,” said Prescott. “The important takeaway message is: get vaccinated. Many of the vaccines you’ll need as you age will give you the best shot at long-term health and can even save your life.”

Free program offers help for those recovering from loss of loved ones

INTEGRIS Hospice and the INTEGRIS Hospice House seek volunteers for the next training session. This free, in-depth training is open to anyone who has a compassionate heart, and provides information necessary to help hospice patients and support for their caregivers.
INTEGRIS Hospice provides care in nine counties, including the metro and surrounding areas. Hospice care includes physical, spiritual and emotional support for the terminally ill. The hospice team is comprises of the medical director, nurses, aides, social workers, chaplains and trained community volunteers.
“INTEGRIS Hospice volunteers provide a unique kind of support to caregivers and patients at critical times,” says Carol Prewitt, RN, manager of Volunteer Services. “Their support makes a big difference and leaves a lasting impression for our families.”
Volunteers may run errands for caregivers, stay with a patient while caregivers take a break, or volunteer their time at the INTEGRIS Hospice House by sitting at the bedside, answering phones or assisting the hospice staff. Hospice volunteers provide special comfort and support to hospice caregivers and patients.
INTEGRIS Hospice and the INTEGRIS Hospice House are affiliates of INTEGRIS, a Medicare certified, non-profit agency dedicated to providing quality care to terminally ill persons and their families.
For more information about the volunteer program or to enroll for training, please contact Carol Prewitt at 405-848-8884.

Becky Payton, regional vice president of operations for Mercy.

Becky Payton, regional vice president of operations for Mercy, has been appointed to serve on the Oklahoma State Board of Health by Gov. Mary Fallin.
The Senate confirmed Payton’s appointment in early May.
Payton got her start in human resources in the manufacturing industry before she joined Mercy as vice president of human resources in March 2008. She has served as regional vice president of operations for Mercy since 2014.
“I am passionate about fiscal responsibility and helping organizations run efficiently,” said Payton. “My goal is to look at how hospitals are collaborating with the state to ensure we’re sharing resources and working together to tackle the biggest health care needs for Oklahomans.”
Payton just completed her term on the board of Mount St. Mary Catholic High School. She currently serves on the boards of Mercy Hospital Ada, Mercy Hospital Logan County, Mercy Rehabilitation Hospital Oklahoma City and Oklahoma Heart Hospital.
Payton will replace current board president Martha Burger, who will become president of Oklahoma City University. Her nine-year term with the Board of Health begins July 1.

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What’s one thing you would change in nursing? College of Nursing at Oklahoma Baptist University

I would say more of an understanding of diverse populations and cultures and how to teach them. Jaime Brantley, MSN, RN, CNE

I would like to change the perception of nurses about their level of knowledge, education and preparation.

Jennifer Sharma, MSN, RN

It would be the implementation of evidenced-based practice. We get bogged down and don’t have enough time.

Shaelene Fipps, MSN, RN

I’d like to see more people get higher degrees. I think it would really benefit our state and our patients.

Rebecca Coon, MS, RN

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Is there any way to strongly encourage someone to get therapy for childhood trauma that has never been processed? My friend has shared the trauma with me but says she has dealt with it and does not want to talk to a therapist. Here is more of her story.
-Teresa

My friend, Nancy has been married three times and strangely enough the profiles of the men are almost identical. Nancy connects to men who are less educated, less motivated, less strong work ethics and controlling. They are attractive and charismatic. She works really hard at her job plus caring for her young daughter. Her ex-husband does not hold down a steady job so child support is rare.
Nancy will acknowledge that she had not made good choices in husbands but hasn’t let herself REALLY do the work and connect the dots.
Nancy is a trauma survivor. When she was a child her grandfather “traded” his wife (her grandmother) for her as a sexual replacement. According to her grandfather (who shared this story many years later), Nancy’s grandmother did not like sex, so he chose Nancy, his 6 year old granddaughter to replace his wife. The sexual abuse lasted approximately 6 years, from the ages 6-12.
Nancy learned to disassociate during the sexual encounters, although she did not know it at the time. It was her way to survive the unthinkable. There were many years in Nancy’s life that she could not remember, i.e., school, holidays, birthdays, etc. There were so many questions. Nancy would frequently remark that something must be wrong with her because of the things she did, i.e., drugs, alcoholic blackouts, promiscuous sex, etc.
The impact of trauma on relationships can be devastating and can show up in a host of issues. Survivors often believe deep down that no one can really be trusted, that intimacy is dangerous, and for them, a real loving attachment is an impossible dream.
Even if the survivor finds a safe, loving partner later in life, the self-limiting scripts stay with them. They cannot just easily toss them and start over. These life lessons are all they have (so far) to survive the best way they know how.
Even with a safe partner, a trauma survivor may
*experience depression
*develop compulsive behavior, an eating disorder, or substance dependence to try and regulate their emotions.
*have flashbacks or panic attacks
*feel persistent self-doubt
Many people do not even realize they have had traumatic experiences and if they do have this awareness they may lack the insight to realize how it is severely affecting them.
More to come in next weeks column.

Oklahoma City man drops 90 pounds and credits OU Medicine team with saving his life

Oklahoma City – When Jerry Trent looked in the mirror, it wasn’t just the excess weight he saw. It was his own mortality. The Oklahoma City man knew his life was in danger.
“It’s a choice. Do you want to live or not? And I wanted to live and not be sick all the time,” Trent said.
Trent’s doctors told him he was more than just overweight. He was morbidly obese. Trent, 71, also had diabetes and both were taking a toll on his body. His joints ached. He had trouble breathing and his blood sugar was high – dangerously high.
“I had lost some weight along the way here and there, but it wasn’t enough,” he said.
His doctor had him on two different kinds of insulin (5 shots a day), metformin and another diabetes medication to try to reign in his soaring blood sugar levels, but the numbers were still alarmingly high.
“Everybody has gone on diets to lose weight. I didn’t go on a diet this time because you will go off a diet,” he explained.
Instead, Trent turned to the Metabolic and Bariatric Surgery Program at OU Medicine. He attended a seminar first.
“I was like, ‘Let’s do it tomorrow,’” he said.
However, Laura Fischer, M.D., and her team know that bariatric surgery success starts long before the patient arrives in the operating room.
“We know that bariatric surgery is a powerful and important tool to help people like Mr. Trent lose weight successfully, but it is only part of the equation. Our clinic combines experts with a variety of medical backgrounds to provide comprehensive care and education. In fact, all our patients are required to meet with our team for in-depth medical, nutritional, psychological, and physical therapy evaluations. The goal is to develop an individualized treatment plan that helps each patient safely and effectively progress toward surgery,” Fischer said.
Before surgery is scheduled, the OU Medicine Metabolic and Bariatric Surgery Program works to help each patient complete the necessary testing and education required to complete the program, including:
* Attending a free Bariatric Surgery Information Seminar
* Working with the weight loss team on diet and exercise changes
* And undergoing a comprehensive medical evaluation
“You do go through some hoops before you get to surgery,” Trent said, but he willingly went through all of them and goals that would need to be met for surgery were set. Trent needed to lose 10 to 15 percent of his body weight. He lost the weight, but there was another hurdle that he still needed to overcome.
“She said my A1C was going to have to be below 8 before she could even begin to do surgery,” he said.
The A1C test is a blood test commonly used to diagnose and then to gauge how well a person is managing his or her diabetes. Trent’s A1C was over 12. It took three months, but finally Trent was there. His A1C hit 7.9 and surgery was scheduled.
Trent underwent a procedure known as Roux-en-Y Gastric Bypass surgery.
“It’s really a two-part procedure in which we first surgically reduce the size of the stomach. With a small stomach, the patient feels full quickly and therefore eats less,” Fischer explained.
“Next, we disconnect the new, smaller stomach pouch from the rest of the stomach and the duodenum (the first part of the small intestine) and connect it to a part of the small intestine farther down, called the jejunum. This reduces the absorption of calories and nutrients.”
Fischer utilizes laparoscopic techniques with small incisions to lessen pain, speed healing and reduce the risk of infection.
Trent called the surgery “a piece of cake” and the results “amazing.” He has dropped almost a third of his body weight.
“I’ve lost 90 pounds. So you can imagine how much better I feel. I am so proud of myself. I was wearing size 50 pants and I have a pair of size 38 that I can get into now,” he said.
Perhaps even more importantly, Trent has finally been able to control his blood sugar levels.
“Since surgery, I have not had to have one shot or one pill of insulin. It saved my life. They are my heroes,” Trent exclaimed, beaming at his success and newfound health.
Trent’s medical team beams with pride too at his success.
“I love my work,” Fischer said. “It is so rewarding to be able to help people reclaim their health and their lives. Bariatric surgery is not for everyone, but for patients like Mr. Trent, it is often the tool that finally allows them to reach their health and weight goals.”
Most insurance covers the procedure and the program has financial specialists in place to assist patients too.
Trent is now walking a little over a mile a day and he’s purchased a new workout machine.
“I’ve been working out and, oh my goodness, it’s made me stronger than I have been in years.”
To learn more about the OU Medicine Metabolic and Bariatric Surgery Program, visit www.oumedicine.com or call (405) 271-9448.

OMRF physician-researcher Judith James, M.D., Ph.D., works with a lupus patient.

Whether your Mother’s Day tradition is serving breakfast in bed, treating her to a spa day, or heading to a movie, the most important part is spending time with mom.
But while we celebrate mothers, scientists at the Oklahoma Medical Research Foundation are working to protect them. Specifically, they’re trying to stop autoimmune diseases, conditions which disproportionately strike women.
Lupus, rheumatoid arthritis and multiple sclerosis are some of the disorders in which the immune system becomes unbalanced and attacks the body. All told, the diseases affect an estimated 25 million Americans.
“Almost all of the 80-plus autoimmune diseases we know are more common in women than men,” said OMRF immunologist Hal Scofield, M.D. “For example, Sjögren’s syndrome makes the body attack its own moisture-producing glands, and it occurs in women at a 9-to-1 ratio over men. Recent studies we’ve done may offer clues as to why it is so female-slanted.”
In a 2016 study, Scofield and his research team found that the diseases may not actually be based on gender—but on how many X chromosomes a person has. “When it comes to understanding the gender bias of autoimmune diseases, X might literally mark the spot,” Scofield said.
Chromosomes determine the biggest difference between males and females genetically. Each person typically has one pair of sex chromosomes per cell. Females have two X chromosomes, while males have one X and one Y.
Scofield said this avenue of research could lead to the discovery of pathways that could be more effectively treated by drugs to reduce the risk of developing these diseases or helping to better manage symptoms.
One way OMRF is already actively helping protect women from autoimmune disease is with the SMILE trial, the world’s first lupus prevention study.
The study launched late last year and is still actively recruiting new participants.
In the trial, researchers seek to identify individuals at high risk for developing lupus and treat them with an immune-modifying medication before they ever transition into the disease. The goal is to delay the onset of lupus, lessen its symptoms and potentially prevent it altogether.
“As a physician, I find this trial incredibly important because I have seen the damage and destruction that happens with lupus,” said OMRF Vice President of Clinical Affairs Judith James, M.D., Ph.D., who launched the project.
James said the ultimate goal is to prevent the disease from ever happening. But even if an individual still transitions into lupus, early detection and getting treatment started before the damage is done can mitigate the potential damage and improve outcomes.
“I think we have opened the door to understanding why there’s a sex bias or gender bias in autoimmunity,” said Scofield. “It could lead to new targeted therapies for autoimmune diseases that could result in longer lives for our sisters, wives, daughters and, of course, our mothers.”

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