News

UArizona Telehealth Certificate Program Swings into Action to Aid with Student Clinical Hours

April 1, 2020

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DNP-FNP student Adriana Warne uses telehealth to conduct remote wellness checks

As people across the country adapt to social distancing and work-from-home measures due to COVID-19, the importance of telecommunications has never been more critical – especially in the realm of health care. Fortunately, the University of Arizona College of Nursing already has a robust telehealth certificate program geared around its Family Nurse Practitioner program, and it’s working to aid both our faculty and students during this challenging time.

UArizona Nursing faculty are creating innovative education for students that don’t place them at risk, while at the same time providing exceptional learning opportunities. One notable example is the College’s partnership with Casa Alitas, a program run by Catholic Community Services of Southern Arizona, Inc. that offers short-term shelter to migrants on the beginning stages of their immigration journey. This semester, students began performing well-child assessments on migrant children at the facility with the goal of preparing them to start school when they reach their sponsor’s home city. Clinical Assistant Professor Audrey Russell-Kibble, DNP, FNP-C, FAANP was supervising rotations for DNP-FNP students – who would be able to earn their full 90 pediatric clinical hours – when the COVID-19 crisis hit. It quickly became clear that for the safety of students and faculty, as well as the migrants, the clinical hours would need to be moved online.


"This is my first exposure to conducting medical screenings via telehealth, and it was an incredible experience. Since I have already completed in-person clinical time at Casa Alitas for the semester, being able to apply a telehealth approach to clinical care, really brought my clinical experience to another level," ~ Adriana Warne, UArizona Nursing DNP-FNP student


Adriana Warne, a student who had already completed 32 of her clinical hours at Casa Alitas and is focusing her DNP project on developing a Migrant Well-Child Health Toolkit for the program, worked with Dr. Russell-Kibble to prepare for the transition to telehealth screenings. Warne began by translating the Casa Alitas Medical Screening Tool into the Spanish language so she would be ready for her first remote wellness check. Working with an intake person to aid in interviewing the first family – a mother from Guatemala and her four children – Warne interfaced with an interpreter to successfully complete the screening. “The intake person gave Adriana high marks for her respectful and culturally competent gentle manner with the migrant mother and her family,” Dr. Russell-Kibble said.

DNP-FNP student Adriana Warne (on screen) conducts a remote wellness check

“This is my first exposure to conducting medical screenings via telehealth, and it was an incredible experience,” said Warne, noting that utilizing telehealth technology is valuable more than ever as students learn how to adapt to assess patients and families during the COVID-19 pandemic. “Since I have already completed in-person clinical time at Casa Alitas for the semester, being able to apply a telehealth approach to clinical care, really brought my clinical experience to another level.”

“Many students are limited to the number of clinical hours we can complete in an actual clinical setting this semester due to this pandemic,” said Warne, pointing out this is the ideal time for students to learn how to navigate telehealth technology and reach people in a clinic setting. “This opportunity allowed me to utilize what I have learned thus far in my didactic coursework about telemedicine and cultural competency. I also applied what I have learned in my clinical work by exercising my clinical judgment without being physically present with the family.”

During her first family screening, Warne built a rapport with the family while providing culturally competent care by working with two interpreters, one who spoke Mam (an indigenous Mayan language) and one who was bilingual in English/Spanish languages. The Mam language interpreter was present at the visit by telephone, but the migrant woman was able to see Warne face-to-face on an iPad furnished by UArizona Nursing. “I know that this experience will enhance my DNP project, and I can’t thank Casa Alitas and the UA CON enough for this unique opportunity to apply this innovative approach to clinical care,” said Warne. “Hopefully, more students will have the opportunity to use telehealth technology during this time, because I have a feeling that once everything settles with Covid-19, telemedicine is going to grow exponentially and become a more common approach to clinical practice.”

“This is an excellent example of the College of Nursing overcoming barriers to clinical education during this time of crisis,” said Clinical Associate Professor and Interim Director DNP Program, Allen Prettyman, PhD, FNP-BC, FAANP, FNAP.

UArizona Nursing Volunteers Fine-Tune Homemade Face Masks to Address Shortage Issues

March 27, 2020

Doing their part to help out during the current COVID-19 crisis, community-minded University of Arizona College of Nursing staff members are aiding in the effort to address the face mask shortage that has challenged health care workers across the country. Three members of the Steele Innovative Learning Center, Yvette Mathesen MEd, BSN, RN, Paige Bravo BSN, RN, CCRN and Terry Bailey, BSN, RN, have developed a homemade face mask pattern with the assistance of Yvonne Flores and Diane Arnold, two members of the Corpus Christi Quilting Ministry. Their work has resulted in hundreds of masks being distributed as close to home as Banner University Medical Center and as far away as North Carolina.

The Centers for Disease Control and Prevention guidelines state that health care providers should use homemade masks such as scarves and bandanas for care of patients with COVID-19 only as a last resort since their capability to protect providers is unknown. The CDC urges caution when considering these options and stresses that they should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.


The Centers for Disease Control and Prevention guidelines state that health care providers should use homemade masks such as scarves and bandanas for care of patients with COVID-19 only as a last resort since their capability to protect providers is unknown. The CDC urges caution when considering these options and stresses that they should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.


Working within these guidelines, Bravo and Mathesen along with their quilting collaborators from the Corpus Christi Quilting Ministry have been diligently working on a fabric-based tie design. While seeking input from local nurses, Mathesen recounts one nurse stated that she used the elastic design mask, but that the elastic didn't fit as well as it was not snug enough to her face. “She liked the tie fit better since it can be adjusted to her face size or around an existing mask,” says Mathesen. 

The current design does not have elastic around the ears, a common feature in many DIY videos that have been circulating. This is beneficial because it will not break down with repeated use and cleaning, is completely adjustable, and can cover the N95 mask. 

Bravo and Matheson have already shared the pattern widely. With the help of sewers in New Mexico, Missouri and North Carolina, they have created hundreds of masks. Bravo has personally made 40 masks that she is sending to North Carolina and California.  Their collaborators at Corpus Christi Quilting Ministry have donated more than 100 masks to the Drexel Fire Department and a hospital in Vancouver, B.C., with the next batch earmarked for Banner UMC.  

“We are all in this together and it’s heartwarming to see our nurses working with community members to sew these for health care workers who may be facing shortages amid this pandemic,” says Connie Miller, DNP, RNC-OB, CNE, CCCE, chair General Nursing and Health Education Division.

People with sewing skills who wish to join in the effort can contact Diane Arnold at FaceMasksTucson@gmail.com in Tucson to get pre-cut fabric masks that they can sew. They can also contact Yvonne Flores FabricfacemasksTucson@gmail.com with questions about the pattern.   

Quilt Basket (6538 E Tanque Verde Rd #130, Tucson, AZ 85715) in Tucson is handing out our kits -- or one yard of free fabric -- so that people can make masks and drop them back off when completed. Calling ahead is recommended: 520-722-8810. 

How to make a SNUG surgical Mask, adult and child size

Designed By Yvonne Flores MEd. (quilter), Diane Arnold, (quilter), Yvette Mathesen MEd, BSN, RN, Terry Bailey BSN, RN, Paige Bravo BSN, CCRN

How to use: Place looped portion overhead, pull face mask up, secure nasal piece, pull ties to cinch sides tight and with tie to back or top of head to secure. 

Can also be used to preserve an N95: fasten N95 as per hospital protocol, follow above instructions to fasten mask over N95.

Materials:

  • Two 6.5x13 inch rectangles cut (length of fabric if possible) out of good quilting cotton fabric
  • One regular size paperclip (.28 mm)
  • One 2x42 inch strip of fabric (WOF-width of the fabric when it comes off the bolt)

Instructions for Adult Mask:

  • Wash fabric in a hot water wash to cause shrinkage and decrease size of holes
  • If possible, boil fabric to cause maximum shrinkage
  • Masks are boiled by the user to clean after each use
  • While fabric is drying unfold paperclips into shape seen in photo. It is important to turn the ends in so it doesn’t puncture the fabric and cause rips
  • Cut two tight cotton fabric rectangles 6.5x13 inches (the two rectangles will be the inner and outer fabric)

 

How to MAKE Paper clip cover:

  • Cut a 2-3" strip (length of paper clip) of batting (from scraps) by 1 1/2 wide
  • Place the paper clip inside it and then stitch around it
  • Center on the lining with raw edge to raw edge and sew all three together leaving a two inch opening at the bottom (FASTER)
  • The paper clip s cushioned, but it's still adjustable
  • Turn rectangle inside out and iron
  • Locate the thick fabric at the top with the paper clip wire.  Sew each side to secure the wire….see red line. 
  • Sew around the entire mask (close the two inch hole at the bottom of the mask)
  • Iron to set the stitches again
  • With the inner side fabric facing up, fold each end at 1 inch and pin to secure
  • Sew these ends three times using your sewing machine to secure the fabric (this is where the most stress is on the mask and we want it to be secure. This is where the 2x42 inch strip will slip in to make the mask adjustable)

How to make the strap:

  • Take your 2inchx42inch strip of fabric
  • Fold it in half and iron
  • Turn each edges towards the middle iron line
  • Turn each edges towards the middle iron line
  • Sew along the edge to close. Your strap is done
  • Place the mask so the fabric that will be seen when wearing is up and the paperclip wire is at the top
  • Thread the strap through going down on the left side and up on the right

       Instructions for child mask:

  • Same instructions as above EXCEPT, cut the rectangle square in 5 ½ x 12 inches
  • You will have to make an adjustment for the length of the strap because 42 inches is too long… I would cut it down five inches or leave it long and it can be cut when adjusted to the individual child
  • This pattern was designed after reading available literature to make the most efficient mask with materials readily available

Video Tutorial:

Reference:

Centers for Disease Control and Prevention. (2020). Strategies for Optimizing the Supply of Facemasks: COVID-19. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html

Davies, A., Thompson, K.-A., Giri, K., Kafatos, G., Walker, J., & Bennett, A. (2013). Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic? Disaster Medicine and Public Health Preparedness7(4), 413–418. doi: 10.1017/dmp.2013.43

Macintyre, C. R., Seale, H., Dung, T. C., Hien, N. T., Nga, P. T., Chughtai, A. A., … Wang, Q. (2015). A cluster randomized trial of cloth masks compared with medical masks in healthcare workers. BMJ Open5(4). doi: 10.1136/bmjopen-2014-006577

Shakya, K. M., Noyes, A., Kallin, R., & Peltier, R. E. (2016). Evaluating the efficacy of cloth facemasks in reducing particulate matter exposure. Journal of Exposure Science & Environmental Epidemiology27(3), 352–357. doi: 10.1038/jes.2016.42

UArizona Nursing Professor Suggests Using Guided Imagery to Deal with Stress and Social Isolation

March 26, 2020

The many “shelter in place” and “stay at home” orders across the country have healthcare researchers concerned about the effects of social isolation. Many people affected by the orders are stuck inside with no access to the outdoors or ability to engage in activities they enjoy. People who cannot go outdoors may experience increased stress and anxiety as a result.

In response to the COVID-19 pandemic, Judith Gordon, PhD, a professor and Associate Dean for Research in the University of Arizona College of Nursing, offers suggestions for dealing with the potential negative health effects of social isolation by using Guided Imagery. Dr. Gordon and her colleagues have used Guided Imagery successfully to help people make positive lifestyle changes, like quitting smoking, eating healthfully, and getting more exercise. Guided Imagery also has been shown to be effective at reducing anxiety.

Guided imagery is a proven method that uses your imagination to help you deal with stressful situations, including social isolation. This technique is also called visualization. But Guided Imagery includes more than just visual images. Guided Imagery involves imagining sights, sounds, tastes, smells, tactile senses, and emotions in a particular situation.

Here’s a sample of Guided Imagery to help you experience how guided imagery works: Imagine you are in a kitchen with a bowl of lemons on the counter. You see their bright yellow color and distinctive shape. You reach out and select a ripe yellow lemon. You feel the weight of the lemon in your hand as you slide your fingers over the dimpled waxy skin. Now, put the lemon down on the counter, pick up a knife and carefully cut into the lemon. You see the yellow flesh and the juice dripping out onto the counter. You smell the sharp citrusy aroma. You cut a slice and put it in your mouth. Bite down on the tart, juicy slice, and let your mouth fill with the tangy juice.

Judith Gordon, PhD

Guided Imagery can help alleviate stress associated with social isolation. You can create a vivid scene in your mind of a place or activity that you find relaxing, like sitting on a long, sandy beach listening to the waves or walking along a desert trail on a sunny day and hearing birdsong. These scenes can take you anywhere you want to go as well as relax you. The possibilities are endless and can be personalized just for you.

The trick to making the most of Guided Imagery is to create a very detailed “script” describing your favorite scenes or activities. Add lots of evocative language (think adjectives like “clear blue sky” or “shiny, smooth green leaves”) and include all your senses, especially slow, deep breaths and relaxed muscles, and feelings of happiness and well-being.

After you’ve created a Guided Imagery script that you like, record it on your phone or ask a friend or family member to record it if you don’t like the sound of your own voice! It's easy to send scripts and audio files by email or text. You can create as many audio files as you like.

Listen to one audio file several times each day until you can “automatically” recall the images vividly. The more vivid the imagery, the more effective it will be at reducing stress. Then, you can move on to the next file. If you can automatically recall the Guided Imagery, you can use it even if you don’t have access to the audio file. 

When you are feeling isolated or stressed, listen to or recall your Guided Imagery. Stroll through beautiful village, hike up a mountain, sail on the ocean. Guided Imagery can take you on infinite, enjoyable journeys!


Guided Imagery can help alleviate stress associated with social isolation. You can create a vivid scene in your mind of a place or activity that you find relaxing, like sitting on a long, sandy beach listening to the waves or walking along a desert trail on a sunny day and hearing birdsong.


Tips for Creating your own Guided Imagery

1. Describe the scene in detail:

  • What do your surroundings look like?
  • Who are you with?
  • What sounds do you hear?
  • What scents do you smell?
  • What do you feel on/in your body or what do you touch?
  • How do you feel/what emotions are you experiencing?

2. Write and edit your “script” using lots of descriptive words.

  • Use lots of adjectives and adverbs.
  • Think about colors and textures.
  • Focus on happy and calm emotions.

3. Record your script as an audio file on your phone.

  • Each type of phone is different, so if you need help recording the file, do an Internet search for your particular model of phone.
  • If you like, pick some relaxing music and play it while you record your script.
  • Ask a friend or family member to record the script for you.

UArizona DNP and MEPN Programs Earn Strong Marks in U.S. News & World Report’s 2021 Best Graduate Schools Rankings

March 23, 2020

Two University of Arizona College of Nursing graduate programs received new rankings in the latest U.S. News & World Report 2021 Best Graduate Schools list. Our Doctor of Nursing Practice (DNP) program was ranked 31 and our Master of Science for Entry into the Profession of Nursing (MEPN) program was ranked 45. As if that isn’t good enough news, our programs ranked high enough to be placed on the highly-coveted list of badge-eligible 2021 U.S. News Best Graduate Schools.

U.S. News & World Report ranks programs based on student engagement, student services and technology, faculty credentials and training, student excellence and expert opinion. Rankings include schools and programs in business, education, engineering, law, nursing and medicine. The rankings in these six areas are based on expert opinions about program excellence and statistical indicators that measure the quality of a school's faculty, research and students.


"Because of the creative talents of faculty, our DNP program continues to be a leader in advanced practice specialties, and in unique informatics and rural telehealth certificates.” ~ UArizona Nursing Dean Ki Moore, PhD, RN, FAAN


“Due to the creative talents of our faculty, the College of Nursing is consistently ranked in the top 50 out of over 500 colleges of nursing across the country and we are proud to carry on that tradition,” said UArizona Nursing Dean Ki Moore, PhD, RN, FAAN.  Our DNP program continues to be a leader in advanced practice specialties and DNP graduates are assuming leadership positions that will insure best health care practices in organizations across the country. The MEPN program is a vitally important degree for retraining individuals to enter the nursing field and prepares students for a wide range of positions. Because of their diverse backgrounds and critical thinking skills, graduates rapidly progress to leadership positions throughout health care institutions.”

MEPN Class, August 2019
MEPN Class, August 2019

With DNP prepared advanced practice registered nurses (APRNs) in demand across the health care industry, our hybrid program allows APRN students to obtain their doctorate in 2.5 years (full-time). The DNP program offers 5 clinical specialties, Adult-Gerontology Acute Care Nurse Practitioner, Family Nurse Practitioner, Nurse Anesthetist, Pediatric Nurse Practitioner, and Psychiatric Mental Health Nurse Practitioner. The UArizona DNP program utilizes a mixture of online didactic coursework, on-campus intensives and clinical placements that are specific for the students APRN specialty.

“The DNP program prepares the next generation of healthcare providers to lead clinical innovation, in a complex and changing healthcare environment, that positively impacts the health outcomes of the people they care for on a daily basis,” said Interim DNP Program Director Allen Prettyman, PhD, FNP-BC, FAANP.

A master's degree in nursing can pave the way for more advanced roles in administration and leadership. With DNPs in demand across the health care industry, our hybrid program allows students to obtain their doctorate in as little as 2.5 years (full-time). The UArizona DNP program utilizes a mixture of online didactic coursework, on-campus intensives and on-ground practicum and clinical placements.

UArizona Nursing’s MEPN Online Master of Science in Nursing Clinical Systems Leadership program is designed to strengthen students’ patient care and leadership abilities as well as expanding their expertise and understanding of emerging interventions and technologies. The program also teaches students about the inner workings of care systems across a spectrum of health environments.

For a full list of UArizona U.S. News & World Report rankings, please visit https://www.usnews.com/best-graduate-schools.

Year of the Nurse Profile: UArizona Professor Cynthia Elliott Honored by the American Association of Nurse Practitioners

March 20, 2020

Continuing our celebration of the World Health Assembly and the American Nurses Association’s Year of the Nurse and the Midwife, we’re zeroing in on one of our stellar University of Arizona College of Nursing faculty members, Cynthia Mote Elliott, DNP, MSN, FNP-C. Dr. Elliot is a dynamic Wildcat Nurse on two important fronts: as a clinical assistant instructor, she monitors distance nursing student in their clinical rotations, and as a nurse practitioner in her private practice, Abundant Health Family Practice, where she cares tirelessly for patients from birth through the lifespan. This year, Dr. Elliott’s hard work earned her the American Association of Nurse Practitioners (AANP) prestigious State Award for Excellence, which is given annually to a dedicated nurse practitioner in each state who demonstrates distinction in their area of practice.

Dr. Elliott began her teaching career at UArizona Nursing in 2016, but her passion for nursing stretches back to childhood. “My mom was a nurse when I was young,” she says. “I remember watching her and thinking, ‘That’s what I want to do. I want to take care of people.’ I really enjoy the whole idea of wholistic medicine – emotional, physical, spiritual.”

Dr. Elliott began working toward her nursing goals after graduating high school and her thirst for knowledge hasn’t abated since: Between 1984 and 2016, she earned her associates in nursing, her Bachelor of Science in Nursing (BSN), her Master’s of Science in Nursing (MSN) and finally her Doctor of Nursing Practice (DNP). In between she spent 24 years as a registered nurse at St. Mary’s Hospital, gaining patient care experience in such diverse specialties as orthopedics, rehabilitation, intensive care, emergency room, respiratory, burn unit, and plastic surgery.


"I love every aspect of both acute and chronic care, but I really like the ability to care for those who are deaf, because they already have a limited access to care and communication.” ~ Cynthia Mote Elliott, DNP, MSN, FNP-C


At the same time, Dr. Elliott worked for 10 years at an Ear Nose and Throat office, during which she gained yet another valuable – and unique – skill: fluency in American Sign Language. “When I was working ENT, they would have deaf patients who required interpreters,” she explains, “so I thought, ‘I’m going to take sign language classes at night so I can communicate with this population.’” Her commitment was strong enough that she focused her doctoral project on communications barriers facing deaf patients.

Sign language has become a cornerstone of Dr. Elliott’s private practice, which she started in 2009. With a staff of five, she cares for a roster of nearly 2,600 patients. “My oldest patient was 104 when she passed,” she says, “and my youngest patients are newborn. I love every aspect of both acute and chronic care, but I really like the ability to care for those who are deaf, because they already have a limited access to care and communication. I give them the same care I give all my other patients and I speak their language, so I know that when they leave they understand their care.”

On top of her part-time duties as a UArizona Nursing faculty member, she estimates that she spends 50-60 hours a week at Abundant Health Family Practice. But that doesn’t mean her UArizona clinical students receive any less love. “I consider my students the same way as my patients,” she says. Outside of her supervising faculty duties, she regularly meets with students to discuss difficulties they may face and to encourage them on their nursing journey. “I really care about how well they do in school,” she says. “And I make sure I do whatever I can to help them succeed. It’s an honor and a privilege to help raise up our next generation providers.”

The relationships Dr. Elliott develops with her students extend beyond the classroom. Since 2014, she has invited students on an annual one-week medical mission to Costa Rica, where she cares for Santa Elena Coffee Farm migrant workers with no access to health care.  Last year, with help from four UArizona Nurse Practitioner graduates, she provided care for 576 people.

That passionate commitment to not just patients and students, but people as a whole, is one of the reasons a UArizona Nursing colleague nominated Dr. Elliott for the AANP’s 2020 Nurse Practitioner Award for Excellence. Asked what the honor means to her, she says, “It’s very humbling to have the organization that I’ve been a member of for 12-13 years choose me. It makes me want to be better at what I do and make sure I’m taking care of these patients the way I should to the very best of my abilities.”

Dr. Elliott will be honored for her achievement during the 2020 AANP National Conference i­­­­­­n New Orleans, LA, on Friday, June 26.

UArizona Nursing PhD Student Recognized with Western Institute of Nursing’s New Researcher Award

March 10, 2020

Last month the Western Institute of Nursing (WIN) announced that University of Arizona College of Nursing PhD student Christine Platt had been selected as the recipient of the 2020 Carol A. Lindeman Award for a New Researcher. Since 1976, the award has provided a fledgling researcher with a $100 cash prize and the opportunity for their research to be included, in its entirety, in WIN’s annual conference.

As a first-year PhD student, Platt is only in the beginning stages of her research, but her study, entitled “Placement Disruption of Children with Disabilities in Foster Care,” has the potential for life-changing results for both disabled children in the foster care system and the families that care for them.

With experience as a registered public health nurse, a hospital staff nurse, and a critical care RN in both cardiac and neuro intensive care units, Platt currently sees patients at her professional dermatologic clinic and volunteers in the evenings to serve the community’s under- or un-insured population. But it’s her 10 years as a foster mom that informs Platt’s very personal interest in her research.


"I love helping people, but I’m at a point in my career when I feel like I can give back to my profession. And the way to give back to my profession is really to make a difference in research and teaching. It’s validation that even when the nights get long and circumstances get challenging, to keep going.” ~ Christine Platt, first-year PhD student


“Because of my intensive care and pediatric clinical experience,” Platt says, “the state really liked to place children with special needs and medical conditions in my home, because they knew that if something went wrong they had someone with the training to handle that situation.” Platt -- who has had more than 14 young children placed in her care over the years -- is intimately familiar with the challenges faced by kids with special needs and the families who care for them.

As a part of the community of families raising foster or adoptive children with special needs, from learning disabilities to severe physical disabilities, Platt saw how foster families grew confidence and strength when things went right, but she also saw how painful results could become when families lacked the resources, education or training to take in a child with special needs. The desire to improve outcomes for this population was the genesis of Platt’s award-winning research.

Her first step was to examine whether what she was seeing in the community – children with disabilities jumping from foster family to foster family and ending up spending more time in the system – was an accurate representation of the facts. An investigation of data and trends revealed this was true. Platt’s second step was to examine the successful resources and protective factors that help foster families provide a stable environment for these unique kids.

“My research will focus on qualitative information and quantitative data to see what help is available, and then look at interventions, whether through training, education, or even political action, to give these kids a real fighting chance and improve the system for them,” Platt says.

Although she has many months of work ahead of her, she theorizes that the right combination of training and education will be key for foster family success. Platt also plans to take a holistic approach with her research, examining how the situation affects not just the foster parents and the foster child, but also any other siblings that may be in the home. “The foster parents may be receiving education,” she says, “but what preparation do the kids in the home have to be able to help out and incorporate a foster child into their home and give them the love and the stability that they need? I want to look at not just the caregiver preparedness, but also the family preparedness.”

That preparedness, Platt theorizes, will lead to improved outcomes for this vulnerable population. With everything stacked against them, she believes her research can ultimately improve their health, not only for the period they spend in state custody, but for their lifetime.

Asked about her feelings about being awarded WIN’s New Researcher award, she expresses pride in being recognized by her peers. “It tells me that what I’m doing matters,” she says. “I love research. I enjoy writing. I love helping people, but I’m at a point in my career when I feel like I can give back to my profession. And the way to give back to my profession is really to make a difference in research and teaching. It’s validation that even when the nights get long and circumstances get challenging, to keep going.”

Christine Platt will receive her award at the 2020 WIN Conference Awards Lunch, which will be held on Thursday, April 16. 

New UArizona Nursing Program Aims to Improve Nursing Career Advancement for American Indian Communities

March 6, 2020

michelle kahn john.jpg

Michelle Kahn-John, PhD, RN, PMHNP-BC, GNP

Thanks to a five-year, $2 million award from the Indian Health Service (IHS), the University of Arizona College of Nursing academic program, American Indians in Nursing: Career Advancement and Transition Scholars (INCATS). The program seeks to increase the number of Bachelor of Science in Nursing (BSN) and advanced-practice Native American nurses who will practice in tribal facilities.

The INCATS program is led by Michelle Kahn-John, PhD, RN, PMHNP-BC, GNP, clinical associate professor of nursing, with mentorship from Mary Koithan, PhD, RN, CNS-BC, FAAN, associate dean of professional/community engagement, and Professor Joan Shaver, PhD, RN, FAAN. INCATS builds on the success of the college’s Arizona Nursing Inclusive Excellence (ANIE) program, a federal Health Resources and Services Administration-funded initiative to improve diversity in the nursing workforce and strengthen efforts that improve inclusivity and student support.


"The INCATS program expands our capacity to partner with our American Indian communities in the shared mission to increase the number of skilled, competent, caring, compassionate Wildcat nurses who will serve as role models and health-care leaders in their tribal communities.” ~ Michelle Kahn-John, PhD, RN, PMHNP-BC, GNP


“I am most grateful to Drs. Kahn-John, Koithan and Shaver for their creative approach to increasing the number of undergraduate and graduate Native American nursing students in the College of Nursing,” said Ida M. “Ki” Moore, PhD, RN, FAAN, dean of the College of Nursing. “With support from this highly competitive national IHS award, the INCATS program will support our efforts to build new partnerships with tribal communities and to increase the diversity of the next generation of nursing leaders.”

Mary Koithan, PhD, RN, CNS-BC, FAAN
Mary Koithan, PhD, RN, CNS-BC, FAAN

A cooperative agreement with the IHS Division of Health Professional Support, INCATS will fund and support nursing career transition and advancement of American Indians and Alaska Natives interested in entering or advancing their nursing careers. It also will create new pathways for associate degree nurses to advance their careers and build new tribal-academic practice collaborations that expand the Native American workforce prepared to improve care of native populations.

“With much excitement, we begin 2020 by supporting five American Indian/Alaska Native scholars on their academic journeys,” Dr. Kahn-John said. “The goal of the INCATS team is to offer an inclusive, safe, supportive and enriching academic experience for every student who attends the UArizona College of Nursing. The INCATS program expands our capacity to partner with our American Indian communities in the shared mission to increase the number of skilled, competent, caring, compassionate Wildcat nurses who will serve as role models and health-care leaders in their tribal communities.”

 

Joan Shaver, PhD, RN, FAAN
Joan Shaver, PhD, RN, FAAN

All of the tribal health-care systems in Arizona's 22 federally recognized tribes/nations report extreme nurse shortages, particularly American Indian registered nurses. Leaders report the most critical needs are RNs who can move between acute and primary care and nurse practitioners in family and psychiatric/mental health specialties.

“The University of Arizona College of Nursing’s firm commitment to inclusive excellence is building a better world for our students and our state,” said UArizona President Robert C. Robbins, MD. “The INCATS program will help create a more diverse and culturally competent nursing workforce primed to serve our community partners.”

Dr. Kahn-John and her team will develop and implement the INCATS program in collaboration with their tribal community partners throughout Arizona as well as other tribal partners in South Dakota and Montana.

To be eligible for the INCATS program, scholars must be American Indian or Alaska Native, enrolled at the UArizona College of Nursing as a pre-nursing or nursing student, and must be nominated by a community partner, such as a tribal clinic, college or organization. INCAT Career Advancement Scholars will receive tailored educational plans to achieve their professional goals, mentorship and academic navigation to ensure best outcomes for each scholar and each tribal community partner. These efforts will result in additional BSN-prepared RNs and advanced-practice American Indian and Alaska Native NPs (nurse practitioners) to practice in tribal facilities.

In addition, the grant supports flexible career-advancing degree pathways for American Indian and Alaska Native RNs with community college degrees through an RN-MSN program in clinical systems leadership. Interactive continuing professional education resources will be created and shared with tribal partners to support and enhance clinical competence and improve the quality of care delivered to tribal communities. College leaders note partnerships with tribal community colleges will foster greater capacity to support tribal and community-based academic programs as “stepping stones” to a UArizona education, as well as enhance the college’s development of a culture that nurtures and sustains American Indian/Alaska Native students.

Year of the Nurse and Midwife Profile: Dorothy Chinyere Igwe, DNP-PMHNP Student

Feb. 25, 2020

The World Health Assembly and the American Nurses Association dubbed 2020 the Year of the Nurse and the Midwife, a year-long effort to celebrate the work of nurses and midwives, highlight the challenging conditions they often face, and advocate for increased investments in the nursing and midwifery workforce. In the coming months, the University of Arizona College of Nursing will be highlighting the contributions of nurses in the community as well as our students, past and present. We couldn’t begin with a better example than Wildcat Nurse Dorothy Chinyere Igwe, who earned her Doctor of Nursing Practice with a Family Nurse Practitioner (DNP-FNP) specialty in 2016 and is currently enrolled as a DNP-Psychiatric Mental Health Practitioner (PMHNP) student.

Originally from Nigeria, Igwe began her career at Obafemi Awolowo University where she obtained her BSN in 1996. Subsequently, she obtained three associate degrees: Registered nurse (1994), Registered midwife (1994) and Registered public health nurse (1996). Her first job after graduating was working as an industrial nurse for ExxonMobil before going in to spend the next eight years working in OBGYN and as a labor/delivery nurse at various Nigerian hospitals.

Why did you pursue a career in nursing?

It was my passion from when I finished high school to be of help to people. Nothing makes me happier than when I put a smile on my patient’s face.

How did nursing school in Nigeria differ from US nursing school?

Universities prepare nurses with a bachelor’s degree, and in the process, you are also trained in midwifery. To be licensed as a nurse in Nigeria, one is also mandated to be licensed as a midwife, which allows hospitals to utilize the same nurse in various job postings in a given hospital. Midwifery and nursing are two certifications and you have to have both in order to get a job. The advantage, speaking for my own training, is that I got a job right away.


"It was my passion from when I finished high school to be of help to people. Nothing makes me happier than when I put a smile on my patient’s face.” ~ Dorothy Chinyere Igwe, DNP-FNP, Current DNP-PMHNP student


How do the U.S. and Nigerian health care systems differ?

The Nigerian health care system is not set up the same as the American health care system. The Nigerian system mostly has a hospital-based set-up. In the hospital, there will be a clinic and there will also be a hospital that also has an outpatient clinic and in in-patient hospital. There will also be an emergency room, just like Banner – University Medical Center Tucson. Nurses get trained to rotate from one unit to the other inside the same hospital, which makes it handy for somebody to have qualifications to allow them to go in different workspaces.

Tell us about the work that nurse midwives do.

In the hospital setting in Nigeria, a nurse midwife will also have the OBGYN section. They will care for pregnant women who come every two to four weeks for checkups, and they will care for non-pregnant women that go for GYN. I also worked in the labor-delivery room as a labor and delivery nurse, because midwives are able to deliver babies under the supervision of an obstetrician.

Why did you choose UArizona Nursing to pursue both your DNP-NP and your DNP-PMHNP?

When I emigrated to the United States, I did my boards and passed. I worked for a little bit before deciding that I needed to move forward with my career and my profession. When I was looking for schools, I applied to several universities but the one that really resonated with me was UArizona. I was very fortunate to attend UArizona Nursing because it helped me become well-rounded. It was rigorous but it paid off in the end.

What advantages will earning a PMHNP have on your career?

I currently work at a correctional facility and there are a lot of challenges here among the inmates. They are stressed and depressed, and there are a lot of psychiatric issues. Being a family nurse practitioner, I see myself as being holistic in my care. I will need to be certified as a psych mental health nurse practitioner. That was my motivation to go back to school and be able to provide more comprehensive care.

What are the most important qualities a nurse can cultivate?

Being resilient and knowing what you want in life. I’m passionate about helping others and being innovative in my care. I learned that from UArizona Nursing. I want to help as many people as I can.

What are your hopes for the future?

I hope that one day I’ll use the education I’ve received to teach in a college of nursing. I want to be innovative in the way that classroom instructions are delivered. I come from a different culture, so I know that when we’re in the classroom there are different ways of personalizing learning to suit the individual needs of the students. I want to create an environment that is conducive to learning, that encourages you to be an independent and motivated learner. I want to impart that to my students when I finally find a place to teach.

UArizona Family Nurse Practitioner Students Provide Compassionate Care to Migrants at Casa Alitas

Feb. 20, 2020

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(L-R) Kristen Olsen and Adriana Warne

When migrant families arrive at Casa Alitas, a program run by Catholic Community Services of Southern Arizona, Inc. that offers short-term shelter to the dispossessed, they are tired, hungry, disoriented and often in need of medical care. They are greeted by a compassionate cadre of volunteers who are ready to shepherd them to the next stage of their immigration journey: travelling from Tucson to sponsors spread across the country in places as far-flung as Washington State and Minnesota. The program offers food, clothing, warm beds and wellness checks. Last month, thanks to University of Arizona College of Nursing Clinical Assistant Professor Audrey Russell-Kibble, DNP, FNP-C, FAANP, UArizona Nursing Doctor of Nursing Practice to Family Nurses Practitioner students (DNP-FNP) have been among the first friendly faces the new arrivals see.

“Casa Alitas has been conducting health screenings for years to make sure the migrants are safe for travel,” says Dr. Russell-Kibble. “But we wanted to do more to help them once they reach their new communities. One of the answers was to do well-child assessments on children with the goal of preparing them to start school when they reach their sponsor’s home city.”

Dr. Audrey Russell-Kibble

Previously, UArizona Nursing faculty have visited Casa Alitas to dispense flu shots, but there was not a concerted effort to entwine the College’s academics and community outreach efforts. Dr. Russell-Kibble changed that by establishing clinical rotations for DNP-FNP students at the facility that will provide them with their full 90 pediatric clinical hours. “Each semester they’ll do a rotation of four weeks for eight hours,” says Dr. Russell-Kibble. The same students will rotate in the summer and then again in fall to complete their hours. FNP students are ideal for the experience because they’re trained to examine how the health care of any individual within a family impacts the rest of the family.


"You don’t have to look too much farther than your back door to find places where you can give care that is meaningful in an international way.” ~ Audrey Russell-Kibble, DNP, FNP-C, FAANP


A formal contract between the College and Casa Alitas was established last year, but it wasn’t until January, 2020, that the new rotations commenced. The program promises to be a success for Catholic Community Services, the UArizona Nursing students and most importantly, the migrant families. That’s a huge boon, considering that since 2018, more than 19,000 migrants – originating from locales as diverse as Honduras, Russia, Mexico, Guatemala, Venezuela, Brazil, Haiti, Ukraine and India – have passed through the facility.

Although Casa Alitas is housed in a former juvenile detention center, you would never know it based on the colorfully painted walls, art and decorations that transform the space into something kinder and warmer. In a Casa Alitas exam room converted into a pediatric clinic, UArizona Nursing students use World Health Organization (WHO) growth charts and American Pediatric Association guidelines to assess their patients, who range in age from birth to 18.

It’s valuable clinical experience for the students, but as Russell-Kibble points, they’re also cultivating important interprofessional skills. “They’re working with volunteer doctors, nurses, a clinical pharmacist, social workers, a lawyer, even the Guatemalan consulate,” she says. “You don’t normally have all these other people at your fingertips for involvement. That’s huge.”

DNP-FNP students Kristen Olsen and Adriana Warne started their clinical rotations on January 22. Warne, who has worked as a pediatric emergency nurse and has done international nursing in Africa, Mexico and India, is thrilled to be doing her part to help migrant families. “International work is a huge passion of mine,” says the Mesa resident, who demonstrates her dedication by travelling from home to Tucson on a weekly basis to complete her clinical hours. “I felt like this was a unique and special opportunity to serve as one of the first people that families get to interact with as they enter the US. Parents are very grateful that their kids get this opportunity to be checked out by medically trained professionals for free.”

Olsen, who has experience in cardiology, women’s health and inpatient/outpatient surgery, echoes her classmate’s enthusiasm. “Many of these people come from poverty-stricken areas,” she says. “It’s not uncommon for them to lack vaccinations, because some moms don’t have any records for themselves or their kids at all. It’s nice to focus on the pediatric aspect of things, and solely learn the developmental milestones they should be meeting.”

Although there’s no such thing as a typical day at Casa Alitas, Olsen and Warne stay busy during their clinical hours. Working as a team, they get basic measurements such as height and weight for their young patients before running through a developmental assessment sheet and finishing up with a head-to-toe physical assessment.

“We ask the moms a ton of questions,” says Olsen. “Not only about developmental things but about dental visits, and their grades in school. Then we plot their height and weight on growth charts and fill out our vaccination records. The mom comes with their records from home and we transcribe it onto what we would use here in the U.S. for entering school.”

The students agree that their work is important not just because it increases their cultural awareness, but because it augments their family practice knowledge. “This experience will help us be more aware of the types of things we deal with in family care in a wholistic way,” says Warne. “Because that’s exactly what the aim of our practice is, to apply a holistic approach to every family and patient that we encounter. And it’s not just the patient that we’re taking care of, especially in pediatrics. We’re caring for the whole family.”

Dr. Russell-Kibble couldn’t be prouder of the work she is supervising. “Adriana and Kristen are amazing,” she says. “They’re very excited, they’re very curious and they’re dedicated to helping an underserved and vulnerable population.” The Nogales native, who knew she wanted to become a nurse since she was four years old, once had dreams of providing high-level care across the world. Now, she says, she realizes that sometimes the most consequential opportunities to give to others are right in front of us. “The point is, you don’t have to look too much farther than your back door to find places where you can give care that is meaningful in an international way,” she says.

UArizona Global Nursing Builds Partnerships for New Binational Experience in Alamos, Mexico

Feb. 18, 2020

With the appointment of University of Arizona College of Nursing Professor Marylyn Morris McEwen, PhD, RN, FAAN as UArizona Nursing Associate Dean for Global Nursing, the College has begun a major new initiative in global education. Microcampuses are currently being examined for potential partnerships in regional hubs in Africa, the Middle East and Asia, but UArizona Nursing has already been forging bonds in Mexico for some time.

Last summer, students in the Master’s Entry to the Profession of Nursing (MEPN) program participated in a clinical experience in Hermosillo, Mexico. And in November, Clinical Assistant Professor Lisa Kiser, DNP, CNM, WHNP laid the foundation for a new immersion-learning binational experience in Alamos, Mexico geared for UArizona Doctor of Nursing Practice students.

A Tucson native who has spent her career working with Hispanic and Latino communities, Dr. Kiser is intimately acquainted with the need for culturally congruent health care that addresses the needs of native communities both in the U.S. and Mexico.

Rotary International District 5500 invited Dr. Kiser to Clinica Integral Almas in Alamos, Mexico, to help provide training and support for fourteen indigenous health promoters (or promatoras) from the Makurawe communities that surround Alamos, Mexico. Together with Southeast Arizona Area Health Education Center (SEAHEC) border binational coordinator Brenda Sanchez and Rotary Global Grants Coordinator Barbara Kiernan, Dr. Kiser travelled to Alamos on a trip that was part exploratory and part instructive. “We did a few trainings but we also wanted to learn about the community,” she says. “Before we brought students to their communities, we wanted to meet them and become introduced to their culture.”


"Clinica Integral Almas is a bridge between the traditional Mexican health care system and their traditional ways of healing and knowing, and we get to help connect both the clinic and the communities to our wonderful nursing community here at the College of Nursing.” ~ Lisa Kiser, DNP, CNM, WHNP, UArizona Nursing Clinical Assistant Professor


Dr. Kiser explains that, just as in the U.S., outlying rural communities like the Makurawe have access to fewer health services. The Mexican health care system attempts to connect with these populations but resources are scarce and travel times for patients to reach clinics are lengthy. “They encourage people to come in, but it’s a two to 7-hour drive on dirt roads, many of which are impassable in winter,” she says.

The goal of the Alamos binational effort is to provide Makurawe health promoters with training, supplies and technology such as solar-powered computer systems in order to increase their access to health care. Both Dr. Kiser and Brenda Sanchez emphasize, however, that the effort was anything but top-down. Cultural sensitivity and engagement were highest priorities for the team.

“I work with promatoras here in Arizona, so I was trying to find the similarities and the differences between the framework that we use here in the U.S. and the framework that is being used in Alamos,” says Sanchez. “They’re the bridge between the health care system and their community. At the end of the day, promatoras know their community best.”

“One of the things we learned is you’re coming into a system where there’s already traditional health care happening,” echoes Dr. Kiser. “With our current efforts around global health, we’re emphasizing to our students a model of global health where it’s not us coming to help. We’re partnering with these communities.”

During their four-day visit Dr. Kiser and Sanchez listened as much as they spoke. They worked with Clinica Integral Almas to determine next steps for needed trainings, community outreach, and potential community health fairs. They conducted direct engagement around reproductive health, basic anatomy, physical assessments, vital signs, and vector-borne diseases like malaria and dengue fever. They also learned about traditional Makurawe ways of healing. “We realized that they’re already doing health care, traditional health care, but still very important,” says Sanchez. “It’s just as valid as western medicine.”

Dr. Kiser wants to bring that realization to the training UArizona DNP students receive when the first immersion binational borderlands learning experience commences in March, 2020. Receiving a fully-funded student learning opportunity is rare, and we are grateful for our partnership with Rotary International District 5500.  This is an important opportunity to demonstrate the valuable contributions of UArizona Global Nursing to support the health of individuals and communities in Alamos, Mexico while focusing on the student educational experience.

Dr. Kiser envisions the seven-day trip as a chance for a fertile border binational exchange.  Two faculty—Dr. Kiser, and Martha Lizarraga de Garcia, MSN, RN, CFNP, will travel to Alamos with six DNP students.  DNP students will have the opportunity to learn from local health care workers about the needs and strengths of their community health knowledge, practices and infrastructure. They will also help develop community health fairs, observe healthcare provided by the Clinica Almas staff, and possibly source ideas for their required DNP projects.

In the end, the opportunity is a gift for both sides of the border. “We get to be bridges between the two cultures,” says Dr. Kiser. “Clinica Integral Almas is a bridge between the traditional Mexican health care system and their traditional ways of healing and knowing, and we get to help connect both the clinic and the communities to our wonderful nursing community here at the College of Nursing.”