A Gentler Way to Combat the Arizona Opioid Crisis: UA Nursing Professor Touts Alternative Pain Management in Elders

June 27, 2018

What do turmeric, frankincense, white willow bark and red wine grape skins have in common? You might be surprised to learn that they are all naturopathic supplements that the state of Arizona’s Department of Health Services (ADHS) has considered for use with pain management issues associated with the current opioid crisis. “Arizona has been forward-moving in initiatives to reduce opioid use and other substance-use issues that came forward with the crisis,” said University of Arizona College of Nursing professor Angela Brown, DNP, FNP-BC, ANP-BC, CDE, who recently completed a presentation of evidence-based alternative therapies utilized for chronic pain titled, “Chronic Pain Management in Elders: Opioid Crisis Lessons.”

Like many states, Arizona has been hard-hit by the opioid epidemic, with drug overdoses of prescription and non-prescription drugs numbering in the thousands. What many people are unaware of is that the epidemic has also hit elder populations hard. With her practice scholarship, Dr. Brown is striving to delineate the connection between elder pain management, the downsides of traditional pain medications and the positive alternative of integrative therapies and non-pharmacological supplements.

“Arizona has been forward-moving in initiatives to reduce opioid use and other substance-use issues that came forward with the crisis." ~ Dr. Angela Brown

In her clinical practice, Dr. Brown witnessed elder patients who had dependence issues with opioids and suffered negative side effects. “It’s important that we give good care to everyone, but especially elders because they do require comprehensive care and sometimes they get lost in our current system,” she said. Seeking a better way, she launched quality improvement in clinical practice by focusing on elders suffering from osteoarthritis and how best to move away from pharmacological solutions to alternative medications and integrative therapies.

Elders are more likely to have arthritis, bone and joint disorders, cancer and other chronic disorders associated with pain, with osteoarthritis being the leading diagnosis associated with chronic pain in older patients. Between 25 and 50 percent of community elders have chronic pain, while between 45 and 80 percent in nursing homes suffer from pain. Downsides include co-occurring diseases or disorders, the simultaneous use of multiple drugs, declining physical and mental health and increased risk of negative drug reactions.

With the release of the 2018 Arizona Opioid Prescribing Guidelines, Arizona’s solution to these dangerous statistics has been proactive, with Dr. Brown being a primary player in the new rules. Along with UA College of Nursing professor S. Renee Gregg, she is one of two UA faculty who are part of a state task force with ADHS. Dr. Brown is working to change curriculum in the DNP program so that it includes more options than just opioids.  “We came together as educators to look at how we’re educating the next generation of prescribers,” she said. That’s good news for proponents of integrative health, who have long argued that alternative therapies are safer, more cost-effective and more effective than traditional pharmacological options.

As a member of the 2017-2018 UA College of Nursing Integrative Nursing Faculty Fellowship, Dr. Brown has become intimately acquainted with the science and benefits of integrative therapies. Elders are significantly affected by the opioid crisis, she points out, suffering side effects like gastrointestinal bleeding, kidney issues, cardiovascular disease and the risk of overdose caused by medication interaction. While opioids like Percocet, Morphine and Methadone represent a clear and present danger, even medications like Tylenol, NSAIDs and antidepressants present health risks. The new guidelines aim to reduce overreliance on opioid therapy, making safety a priority in managing acute and chronic pain.

With her focus on osteoarthritis pain management, Dr. Brown’s presentation shows that the use of non-opioid medications and therapies as first-line treatment for mild and moderate acute pain can be a successful option. In recent years the American College of Rheumatology and the American Geriatric Society recommended such integrative therapies as Tai Chi, acupuncture and chiropractic care. Therapies such as massage, meditation, yoga and music therapy have also gained credence with researchers. Then there are the aforementioned supplements like frankincense, white willow bark and red wine grapes skins, all of which are proven remedies for arthritis, reflux, nausea and pain and inflammation.

There’s still much work that needs to be accomplished state-wide, but Dr. Brown is ensuring that awareness and training in the area of elder pain management moves forward in a progressive way. “There needs to be more dissemination in regards to integrative interventions, and there certainly needs to be more studies,” she says. “In the future, you’re definitely going to see much more information about these alternative therapies. We’re starting with our DNP students to make a difference in the realm of higher education.”

CVS Scholarship Allows Five Bilingual UA Nursing Students to Support Underserved Populations

June 25, 2018

Continuing a tradition that began last year, the CVS Health Foundation recently awarded $5,000 in scholarship funds to support five Family Nurse Practitioner (FNP) students in the University of Arizona College of Nursing’s Doctor of Nursing Practice program. The scholars were selected based on their interest in family or retail healthcare practice, their stellar academic standing, their bilingual skills and their desire to spend a portion of their time with organizations that support underserved populations.

“The CVS Health Foundation focus on supporting Family Nurse Practitioner students aligns wonderfully with the academic mission of our Doctor of Nursing Practice program,” said Clinical Associate Professor and Director of Practice Innovations, Allen Prettyman, PhD, FNP-BC, FAANP. “The support from the CVS Health Foundation allows student awardees to academically shine a little brighter while providing volunteer healthcare for underserved communities now and in the future.”

Take a moment to meet this year’s CVS scholarship awardees and hear what this funding means to them:

Daniel O. Maduma
UA College of Nursing
Daniel O. Maduma

Daniel O. Maduma: “I used to be a veterinarian, and I really wanted to get back to working with people – specifically families. That’s why I chose to pursue an FNP. While I work in a major hospital, it’s not a natural environment, so it was important to me to be somewhere that’s natural where I can interact with people living their lives. In the future, I plan to provide primary care to families in Tucson. I also want to be involved in teaching future nursing students.”

Megan Maley
UA College of Nursing
Megan Maley

Megan Maley: “I decided to pursue an FNP because I wanted to be able to give more to patients that my current RN role does not allow. With an FNP, I can help each step of the way from diagnosing to formulating a treatment plan. Receiving the CVS scholarship means I can focus more on my studies to be more prepared for caring for patients on my own after graduation. The work I will be doing through my preceptorship involves caring for patients throughout their lifetime. I will begin working in a rural pediatric clinic this summer which I am looking forward to.”

Stephanie Marks
UA College of Nursing
Stephanie Marks

Stephanie Marks: “I chose to pursue an FNP because I am passionate about providing quality, holistic care to persons of all ages. I feel strongly that mental, social and spiritual wellbeing are just as important as physical health. As an FNP, I am afforded the special opportunity of empowering my patients through education, medical care, and support over the course of their lifetime.  Receiving the CVS Scholarship means that I am able to dedicate more time to my studies and clinical experiences, consequently optimizing my patients’ health through innovation, collaboration, caring, integrity and accountability: values that reflect CVS Caremark’s mission. This scholarship means that the work I am doing, and plan on doing after graduation, is important to my community.”

Nila Safaeian
UA College of Nursing
Nila Safaeian

Nila Safaeian: “The idea of being able to provide care across the lifespan appealed to me. FNPs have the unique opportunity to not only care for the health and well-being of the individual, but also for the family as a unit. Whether it be for our pediatric or geriatric patients, we have the ability to educate and empower them to take charge of their health through health maintenance and disease prevention measures. I also enjoy being able to see a variety of conditions in practice, from acute to chronic illnesses. You never know what you’re going to get, but that’s what makes it interesting. I am truly honored and grateful to receive this award. The CVS Scholarship will greatly assist me in reaching my goal of graduating in December and being one step closer to working as an FNP.”

John Sparks
UA College of Nursing
John Sparks

John Sparks: In my prior career I worked in corporations for a large company. As I got older I wanted to have an impact on people around me in a more positive way, so I chose to enter the medical field so I could help people. It fits my personality a little better and I enjoy interacting with people and helping them to solve problems and 2 meet their needs, and do so by helping themselves, too, in the process. Financially, it makes a big impact. I’m an older learner, and I have 4 children and I’m married, so assistance helps me and my family meet my goals to become a DNP and also maintain financial solvency during that time.”

“The CVS Health Foundation focus on supporting Family Nurse Practitioner students aligns wonderfully with the academic mission of our Doctor of Nursing Practice program." ~ Dr. Allen Prettyman

At the UA College of Nursing, students pursuing the Family Nurse Practitioner (FNP) specialty receive a broad foundation of educational preparation in advanced nursing practice with families across the lifespan. Through a variety of service and learning opportunities, all nursing students apply the knowledge and skills they’ve gained in the classroom to real-life health challenges in our communities. Proximity to the Mexican border and tribal communities offers opportunities to serve and learn about issues in health and culture. Clinical sites available in the community and surrounding rural areas include nurse-managed clinics, health maintenance organizations, Indian Health Service sites, community health centers, physician-nurse practitioner practices, mental health centers, health departments, long-term care settings, retirement centers, schools and acute care settings. Last year we were delighted to receive CVS Health Foundation Scholarship funds for two of our FNP students. These two students, both of whom are bilingual, have excelled in their academic trajectories and plan to practice in primary care.

UA College of Nursing Receives $1.6M Grant to Examine the Healing Potential of Curcumin for Acute Lung Injury

June 19, 2018

People with a high dependence on alcohol at risk of developing serious – and sometimes fatal – complications from respiratory inflammation soon may have a naturopathic supplement that would mitigate their risk factors.

Alcohol abuse is a significant contributor to the development of acute respiratory distress syndrome, which kills 114,000 Americans annually.

Alcohol abuse depletes intracellular glutathione, or GHS, a critical antioxidant in the lung. Research has shown that when GSH combines with oxygen, it impairs protein function and can result in fatal respiratory failure.

Curcumin, a compound found in turmeric, has proven effective as a nonpharmacological treatment for a variety of inflammatory diseases, and an increase of GSH synthesis.

Looking to evaluate curcumin’s effectiveness in facilitating the normal production of GSH, University of Arizona College of Nursing Assistant Professor Charles Downs, PhD, ACNP-BC, FAAN, has received a five-year $1.6M RO1 grant from the National Institutes of Health.

Charles Aldon Downs , PhD, ACNP-BC, FAAN

Using a carefully designed murine model in his study, “Using Proteomics to Develop Personalized Health Strategies to Prevent Lung Injury in Model Systems,” Dr. Downs hopes to demonstrate that curcumin reverses impaired protein function to restore lung fluid balance.

Acute respiratory distress syndrome occurs in response to inflammatory stresses such as pneumonia and is characterized by profound inflammation and a build-up of excess fluid in the lungs that culminates in respiratory failure. Although researchers are aware of the physiological disorders associated with the syndrome, current therapies are supportive rather than curative, Dr. Downs said.

“This project is part of a long-term effort that will elucidate the molecular underpinnings of acute lung injury but also will test the ability of a water-soluble formulation of curcumin to prevent and/or treat acute lung injury,” said Dr. Downs. “We hope this study will move the science forward and ultimately lead to the development of potential therapeutics.”

The results could have other wide-reaching benefits.

“We hope this study will move the science forward and ultimately lead to the development of potential therapeutics." ~ Charles Downs

“Understanding the cellular and molecular determinants of lung injury is critical for the development of effective targeted interventions,” said Usha Menon, PhD, RN, UA College of Nursing associate dean of research and global initiatives. “Dr. Downs’ current study is a major and important step toward his long-term goal to develop precision-health strategies to reduce the risk for lung injury and to improve outcomes for those affected.”

"It is fitting that the UA College of Nursing is pursuing this project. As one of the top 15 percent graduate nursing programs in the nation, with a strong emphasis on integrative health across research, clinical and teaching projects, this is an area in which we can have great impact," said UA President Robert C. Robbins, MD. "Integrative health care presents a dynamic frontier as we seek to broaden our treatment resources to include more than just traditional pharmacological options. Dr. Downs' research contributes to the University of Arizona’s goal of leading the world in novel approaches to healthcare research and teaching."

Dr. Downs’ multi-disciplinary team includes co-investigators Joe G.N. “Skip” Garcia, MD; UA College of Medicine; Janet Funk, MD, UA Cancer Center; Dean Billheimer, PhD, UA Mel and  Enid Zuckerman College of Public Health; George Tsaprailis, PhD; UA College of Pharmacy; Monica Jablonski, PhD; University of Tennessee Department of Ophthalmology.

Student Spotlight: Cristina Rae Stuefen

June 18, 2018

First-Year PhD Candidate from the Rio Grande Valley, Texas.

Why did you decide to pursue a nursing degree?

Several roads drew me towards Nursing, including life-threatening injuries my dad sustained in Iraq, and the life and health experience of my maternal grandmother. She was undocumented for many years and lacked access to quality healthcare. This resulted in health effects that changed the trajectory of both her and my families’ lives. From these two experiences, I began to understand the pivotal role that nurses have in ensuring high quality healthcare, addressing health disparity and advocating for health equity.

I was actually originally an English Literature major and wanted to specialize in Southern Realism. The economic aspect definitely played a role in switching my major, as I was a young mom and needed a secure profession. But that being said, I loved Nursing, and if I didn’t, I wouldn’t have been able to stay with it for this long (9 years) and have joy in my work. 

What drew you to the UA College of Nursing?

Completing my Master’s Degree at the UA was a very positive experience. I also was drawn to the Nursing focus on addressing health disparity, equity and population health. Additionally, Dr. Michelle Kahn John, who is now my advisor, is from the area where I live and I was drawn to her work and approach. I was able to talk to her early on and knew that I wanted to work with her.

What features of your program are you especially passionate about?

I really appreciate being able to work with faculty with shared values. I think the focus on equity is very important, not just to me, but to my entire cohort. That, and a commitment to social justice issues. As I tell my students, social justice issues are health justice issues. As nurses, whether at the bedside or in our communities, we see the end result of inequity and social injustice in the health and wellness, or lack thereof, in our patients. And in ourselves too, in all honesty. 

Share your favorite memory from your time at the CON.

I’ve had a great experience so far with the CON. My advisor, Dr. Michelle Kahn John, is supportive and really motivates me to achieve, even during difficult times. Dr. Rosenfeld was also wonderful, as is Dr. Loescher. Actually, I’ve felt that the faculty have been outstanding.  My favorite experience has been attending the Western Institute of Nursing Conference this April with six other members of my cohort who were also first-year attendees. It was great to reconnect with everyone and see how people’s interests are evolving.

How do you intend to build better futures?

There are several ways I hope to do this, and so many relevant ways in which this can be done. I would hope not to attempt to build anything on my own, but to work towards health equity and justice in solidarity and as an ally with others with shared values and goals. I hope to apply the skills gained in doctoral study to partner with Indigenous and Mestizx communities in supporting health and wellness using decolonized and strength-based approaches and by supporting cultural determinants of health, focusing on inherent strengths. Although it is important to recognize health deficits and disparity, I truly believe that strength- and asset-based approaches have the potential to address health and wellness in a more optimal way, and in a manner respectful of many individual’s and community’s value systems.  

Another aspect that is very important to me is to maintain a reciprocal relationship with my community. I work with NAU’s American Indian Nursing Program. I love teaching and it’s really awesome to see our students learn and grow, and to support their learning and potential along the way. Another area relevant to this question is partnering for better futures via policy and legislation. As we speak, there are a number of legislative and policy related decisions being made that will directly and indirectly affect health and wellness.  Nurses are in a unique and well-positioned role to have a strong voice in these conversations and decision making processes. 

Where are you from originally? 

I was born in the Rio Grande Valley in South Texas, lived in different States as my Dad was in the Marines and Army, then grew up in South Dakota, and have lived in Navajo Nation for most of the last nine years. So, kind of all over. 

Do you have any other degrees?

I received my BSN from South Dakota State University, and MSN from the UA. After this, I’d like to consider a MPH.

Are you funded by a scholarship?

I am a Robert Wood Johnson Foundation Future of Nursing Scholar in Cohort 4. This has been an amazing opportunity and an honor. I am the parent of four children ages 5-17, so being an FNS Scholar with the associated grant has made a huge difference in being able to pursue this dream. Additionally, the resources, networking, webinars, and intensives associated with FNS have contributed greatly to my personal, professional, and academic growth. 

College of Nursing Receives $2.5M Grant to Improve Interventions for Cancer Survivors

June 4, 2018

Cancer survivors who suffer negative effects after treatment soon may have access to interventions with the potential to vastly improve their quality of life.

University of Arizona College of Nursing Professor Terry A. Badger, PhD, RN, PMHCNS-BC, FAAN, has received a $2.5 million grant from the National Cancer Institute to help improve symptoms for cancer survivors after their treatment.

Dr. Badger will employ the interventions and determine their effectiveness among ethnically diverse cancer survivors who have gone through medical treatment. One intervention will be made available in Spanish for the first time, Dr. Badger said.

Nearly 15.5 million American cancer survivors have experienced symptoms from cancer treatment that negatively impact their quality of life, according to the American Cancer Society. Although numerous symptom-management interventions have been tested during cancer treatment, few have addressed the continuing fatigue, pain, depression, anxiety, insomnia and other symptoms that continue after treatment has ended.

Dr. Badger, who also is a UA professor of psychiatry, will use two post-treatment innovations in her study. The first is a printed Symptom Management and Survivorship Handbook featuring evidence-based, self-care strategies for symptoms. The second is a more intensive intervention that combines the handbook with a telephone interpersonal counseling intervention for managing depressive symptoms.

Symptom Management and Survivorship Handbook

Dr. Badger's interest in improving quality of life for cancer survivors began 18 years ago when she first conceived the idea of delivering interventions over the telephone. Many of Dr. Badger's previous studies focused on helping survivors during medical treatment. But in her latest work she examines the effectiveness of interventions post-treatment.

"One unique element of this study is that we are taking survivors after they have completed their chemotherapy, which is a time when they are transitioning back to their primary care provider. But they have a lot of unmet needs and lingering symptoms," she said.

“The Symptom Management and Survivorship Handbook is the first handbook of its kind to be made available for our Spanish-speaking cancer survivors." ~ Dr. Terry A. Badger

Dr. Badger will examine the effectiveness of the two interventions for managing symptoms in an ethnically diverse – about 30 percent Hispanic – sample of cancer survivors of solid tumors at the end of chemotherapy. Though the telephone intervention may not be "high-tech," its accessibility has proven to be a boon to cancer survivors. An important part of Dr. Badger's work is removing barriers between patients and their care.

"All my work is developed to remove barriers so that survivors can get the supportive care they need in a cost-conservative, timely and convenient way," she said. "The Symptom Management and Survivorship Handbook is the first handbook of its kind to be made available for our Spanish-speaking cancer survivors. In fact, both interventions are delivered in either English or Spanish, depending on the survivor's preference."

In development for almost a year, the handbook is heavily illustrated and easy to navigate. It was translated by a certified interpreter and revised after a focus group was held with Spanish speakers.

"We have made incredible advances in treating cancer, and we are now at a point where many people survive a cancer diagnosis,” said UA President Robert C. Robbins, MD. “However, many people still suffer from the very treatments that saved their life. The work that Dr. Badger is doing to help them as they move from being cancer patients to cancer survivors is addressing an important and unmet need. I am pleased to see that these interventions will be available in English as well as Spanish, which will help ensure that a greater number of people benefit from them."

Dr. Badger's team includes Chris Segrin, PhD, UA College of Social and Behavioral Sciences; Tracy E. Crane, PhD, UA College of Nursing; Pavani Chalasani, MD, MPH; UA Cancer Center; and Alla Sikorskii, PhD, Michigan State University Department of Psychiatry. The study began March 1 and has begun enrolling survivors.

"Thanks to this research, in the future we will be able to offer the right intervention, in the right dose, at the right time to our cancer survivors so that post-treatment symptoms can be reduced and healing hastened with these supportive interventions," Dr. Badger said.

Eight Ways to Play it Safe in the Sun

May 31, 2018

Lois Loescher, PhD, RN, FAAN, professor at the University of Arizona College of Nursing, the Mel and Enid Zuckerman College of Public Health and the Skin Cancer Institute at the UA Cancer Center is acutely aware of the vital importance of sun safety. A zealous advocate for the cause, she was drawn to sun safety research because she was fascinated by how such a serious cancer - that can be challenging to treat - is so easy to prevent. Skin cancer, the most common cancer in the US, is increasing in incidence and can be fatal.

“Respect your skin,” she says. “The skin is your largest organ, your body’s first line of defense, and is your body’s ‘roadmap’.  I started regular application of sunscreen when I was 30, but I had already damaged my skin so much before then. If I’d started 20 years earlier my wrinkles and skin spots would be much fewer today. That’s a message that we need to emphasize with today’s youth.”

With the sunniest part of the year upon us, Loescher has some tips for skin cancer prevention.

UA College of Nursing
Lois Loescher, PhD, RN, FAAN,
  1. Fair Skin = Extra Precaution. Everybody is at risk, but the fairer the skin, the bigger the risk. If you have a skin type that burns easily – fair skin, blue eyes, blonde/red hair—you have to be extra careful. But remember, even if you have very dark skin, you can still be at risk.
  2. Sun Damage Adds Up Quickly. Sun damage is cumulative and sun safety needs to start very early in life. Make sure babies and children are protected.
  3. Re-Apply All Day. Block the sun. Cover up. Wear a hat, preferably wide-brimmed. Wear sunglasses.  Apply and re-apply sunscreen to sun-exposed areas even after you’ve taken those precautions.
  4. The Equation for Your Protection. Know how to interpret sun protection factor on sunscreen: Multiply the time it takes your skin to burn by the SPF on your sunscreen (e.g. if your skin burns in 5 minutes and you apply SPF 30 sunscreen, you will have 150 minutes of protection).
  5. Shade Can Be Your First Defense. Avoid being outside or seek shade from 10AM – 4PM, when the sun’s rays are at their most damaging.
  6. Avoid the Booth. Avoid tanning booths and artificial tanning. Studies show these significantly increase chances of skin cancer.
  7. Get Naked… And Look at your Skin. Observe your skin. Know your moles and skin spots. If you can’t see parts of your skin have somebody else take a look. Check for any changes in spots such as size, shape, color, texture and sensation.
  8. Follow through and See a Dermatologist. See a dermatologist if you find a mole or skin spot that is changing or new. A change in a mole could be change in size, shape, color, texture, sensation. 

Questions or concerns about the dangers posed by the summer sun? Find additional information at the Skin Cancer Institute at the UA Cancer Center.

Dr. Loescher’s passion is the study of skin cancer risk reduction and preventive behaviors. She has received funding for her research from the NIH, the State of Arizona, private foundations, and through collaborations with universities in Queensland Australia. As part of her joint appointment in the College of Public Health, she has developed and evaluated skin cancer prevention hybrid training for health sciences students. As a longstanding member of the UA Cancer Center, she has several years of experience developing and evaluating public and professional outreach education sun safety programs.

UA Receives $1.7M Grant to Increase Number of Mental Health Nurse Practitioners in Rural and Border Areas

May 29, 2018

Communities outside major metropolitan areas often have little access to mental health care, but a grant recently awarded to the University of Arizona College of Nursing will give a new generation of nurse practitioners the training to work in those settings.

Thanks to funding from the U.S. Health Resources and Services Administration Behavioral Health Workforce Education and Training program, the UA College of Nursing is launching a project to increase the number of psychiatric mental health nurse practitioners in rural, border and medically underserved communities.

Over four years, the $1.7 million in funding will enable nine students each year to help pay for school and hone their skills at rural, border and medically underserved sites specially chosen for a focus on interprofessional collaborative care.

Rene Love, PhD, DNP, PMHNP-BC, FNAP, FAANP, clinical associate professor and director of the UA College of Nursing’s Doctor of Nursing Practice program, is principal investigator for the grant.

Rene Allen Love , PhD, DNP, PMHNP-BC, FNAP, FAANP
UA College of Nursing
Rene Allen Love , PhD, DNP, PMHNP-BC, FNAP, FAANP

“Arizona has vast areas where people have limited to no access to care,” she said. “They either have to travel or they don't get services. My thought behind applying for this grant was, ‘Can we promote and help these students so they will see the value in working with patients in integrated settings in rural and medically underserved areas?’ And beyond that, ‘Can we encourage them to stay and help these patients in Arizona once they’ve graduated from the program?’”

“As Arizona’s flagship university, it is vitally important that the University of Arizona helps address the needs of our state. This includes providing quality mental health care for everybody who lives here, especially those in communities where access to care is limited,” said UA President Robert C. Robbins, MD. “I’m glad to see that the College of Nursing is helping to meet this need while also strengthening training for nurse practitioners, who hopfully will choose to serve these areas once they begin their careers.”

The project is a bold step forward for nurses in the psychiatric mental health nurse practitioners field, Dr. Love said.

“A big part of this project is about learning to work with other health-care professionals. Can we collaborate to give the best possible care to people who otherwise might not receive care?" ~ Dr. Rene Love

“It’s very different from the way I learned to practice originally,” said Dr. Love, whose clinical expertise is as a psychiatric mental health nurse practitioner. “Traditionally, a real stigma surrounded mental health. Psych providers were housed away from everyone else because no one wanted it known they (patients) were seeking mental health services.”

The funds from the grant will continue to break down those barriers: An important focus of Dr. Love’s project is to foster interprofessional collaborative care at rural facilities to which students are assigned.

“A big part of this project is about learning to work with other health-care professionals,” she said. “Can we collaborate to give the best possible care to people who otherwise might not receive that care?”

Another unique element of the study involves the length of training students will receive at the sites, which include facilities in northern Arizona and outside Tucson, as well as in New Mexico and Oregon. Training will happen at one site for at least six months to support understanding of interprofessional care in rural and medically underserved locations. Typically, students participating in clinical practice move to several sites in different geographic locations and might spend no more than one semester at a single location.

“Students really will be immersed in a community of practice that will give them knowledge they might not gain at other places,” Dr. Love says.

In addition, the collaborative aspect of the study will be stressed: Students will be encouraged to attend staff meetings with other health-care professionals to help foster a team perspective. Their training also will involve working on assessments, diagnosis and treatment, giving students a thorough exposure to the challenges and rewards of working in underserved communities. Dr. Love hopes they will be inspired by their experiences and choose to seek work in those same communities following graduation.

Nine inaugural students are set for placement in the program in 2018. One of those students, Catherine Clare Dockery-Jackson, is in the final year of the specialty program and has high hopes for her time in the newly created program.

“It will allow me to experience an integrative care practice that addresses the patient more completely,” she says. “For me, nursing has always been a holistic discipline, so I’m looking forward to seeing how the clinical site will address a patient’s mental and physical needs.”


New Telephone-Based Intervention to Assist Latino Cancer Survivors and Caregivers

May 22, 2018

With obesity now linked to 13 different cancers, pursuing interventions focused on healthy eating and exercise are of critical importance for the health of cancer survivors and their caregivers. After a diagnosis of cancer, many survivors report lingering symptoms such as fatigue, depression, anxiety, pain, and disrupted sleep. These symptoms are often a barrier to the adoption of healthy lifestyle behaviors such as diet and physical activity; behaviors known to impact cancer progression. “Our goal is to integrate symptom management with lifestyle behavior modification to improve diets and increase activity while managing symptoms,” says Dr. Crane. “We have evidence-based interventions for each of these things separately. We have effective lifestyle interventions and ways to manage symptoms, but this study is about pulling them together to see how they can work synergistically to benefit each other.”

“We have effective lifestyle interventions and ways to manage symptoms, but this study is about pulling them together to see how they can work congruently to benefit each other." ~ Tracy Crane

In January, University of Arizona Assistant Professor, Dr. Tracy Crane was awarded one of three $30,000 American Cancer Society (ACS) Institutional Research Grants (ACS-IRG) for her new study, “Improving Adherence to ACS Guidelines on Nutrition and Physical Activity through integrated symptom management in Latinas with cancer and their informal caregivers.” 

Dr. Crane’s application was a follow up to a study she completed last year with College of Nursing Professor and Director of Community and Systems Health Sciences Division, Dr. Terry Badger, which identified the high symptom burden experienced by Latina breast cancer survivors. Realizing the detrimental impact these symptoms have on quality of life, Dr. Crane wants to address the next question: How best to manage the symptoms and at the same time help survivors adhere to healthy lifestyle behaviors involving diet and physical activity to reduce risk of cancer recurrence.

“It’s a telephone-based intervention,” explains Dr. Crane. “Theoretically, anybody anywhere can receive it. We work with them to identify the symptoms they’re experiencing and then tailor the lifestyle intervention to either alleviate these symptoms or avoid making these symptoms worse in an effort to increase activity and improve diet.” A novel aspect of the study is the involvement of an informal caregiver of the survivor’s choice to participate with them in the study. “We know from our past research, caregivers experience similar symptoms that directly impact the well-being of the survivor. Oftentimes, caregivers neglect self-care, which opens them up to negative repercussions as well,” Dr. Crane points out. “It never hurts anybody to eat better and exercise more. By including the caregiver as well, we believe this partnership will facilitate the most successful behavior change.”

The study is currently underway with more than a dozen dyads participating in the telephone-based intervention. Dr. Crane anticipates that it will take about a year to recruit 36 patients and their informal caregivers for the 12-week lifestyle intervention. Dr. Crane’s research lab is comprised of undergraduate and graduate students who deliver the telephone-based intervention, a model that not only benefits study participants but also serves to train students in the rigors of delivering successful interventions. “When you give students hands-on, real-life experience, you’re only benefiting everyone in the long run,” says Dr. Crane.

With a clinical background as a registered dietitian, Dr. Crane has been working with cancer survivors for nearly 20 years, to improve their diets and physical activity. Her goal of preventing cancer and helping survivors live the healthiest life possible hasn’t changed, but expanding her interventions to informal caregivers and integrating symptom management will expand her ability to find solutions to the complex problem of changing behaviors and managing symptoms.

Tracy Crane, PhD, MS, RDN, is an Assistant Professor at the University of Arizona College of Nursing

Six UA College of Nursing Faculty Honored as 2018 Tucson Fab 50 Nurses

May 14, 2018

As part of National Nurses Week (May 6-12), held in honor of the largest health-care workforce in the United States, six nurse leaders from the University of Arizona College of Nursing were honored by their peers during an annual 2018 Tucson Fabulous 50 Nurses gala held by the Tucson Nurses’ Week Foundation on Saturday, May 12. 

The 21st annual event is the city's capstone celebration to National Nursing Week and is sponsored by the Tucson Nurses Week Foundation. The Fabulous 50 nurses were chosen from throughout the Tucson area by their peers for their role modeling and mentoring of others, concern for humanity and their contributions to the Tucson community and the profession of nursing.

UA College of Nursing ‘Fabulous 50’ Nurses:

Carolina Baldwin, DNP, RN, CCRN, Clinical Assistant Professor

“I am humbled at the thought someone noticed my work and took the time to nominate me for this very prestigious award. It is difficult to put into words the sense of accomplishment I feel at entering the ranks of outstanding nurses who have won the Fab 50 award. My hope is to inspire others as I have been inspired by past awardees.” 

Michelle Kahn-John, PhD, RN, PMHNP-BC, GNPDNP, RN, CCRN, Assistant Professor

“I’m grateful and honored to be recognized as one of Tucson’s 2018 Fab 50 nurses.  The Fab 50 honor was certainly a surprise and motivates me to continue my work with teaching, mentoring and research.  I’m also truly thankful to work with and collaborate with Fabulous nurse colleagues here at the UA College of Nursing.”  

Mary Koithan, PhD, RN, CNS-BC, FAAN, Associate Dean, Professional/Community Engagement, Associate Professor

“Being recognized by peers for leadership and innovation as well as a commitment to the profession is very special. These are the folks who see you every single day, those you work alongside.  They see you at your best as well as your worst and are willing to forgive the missteps to see your potential. I’m incredibly grateful for their support and am feel honored to be one of the many UA CON Fab 50s.”

Mary O’Connell, MA, RN, PHN, Senior Lecturer

“I feel honored and privileged to receive the Fab 50 award, given the breadth of other accomplishments, life experiences and their overall desire to serve others. I am fortunate to be recognized among so many well-educated individuals and giving members of our community.”

Linda Perez, M Admin, RN, Senior Lecturer

“I am privileged and proud to be selected to stand among all the other fabulous nurses that have been honored since 1995. We have many fabulous nurses in Tucson and we all do so much for our community in different ways. I often don’t see the work I do as special because it is not about me, but about how to make it better for others. That is my life’s mission and I am honored to be viewed in the same light as so many others that emphasizes professionalism, education, research, and personal vitality.”

Carrie Silvers, MSN, RN

"Receiving the Fabulous 50 Award for my many years as a nurse is a great honor. I think what is most flattering to me is that one of my friends and colleagues took time to nominate me for the award."

UA College of Nursing Class of 2018: Connie Tran

May 8, 2018

Connie Tran was drawn to the nursing field at a young age. After interning at a hospital during high school, she was impressed by the hard work and dedication she saw nurses exhibit on the job. “I wanted to become one of those people who support patients through the best and worst times of their lives,” she says.

With her future decided, the University of Arizona College of Nursing—with its high rankings and helpful financial incentives—was an obvious choice for her academic ambitions. Tran was in the first group of Arizona Nursing Inclusive Excellence (ANIE) scholars, a landmark program designed to attract and support the success of students from diverse settings and cultures that are underrepresented in health care.

Thanks to ANIE funding, Tran was able to participate in a community health clinic for low-income Spanish-speaking residents in South Tucson. “The ANIE grant is great because it’s really fostering the growth of a diversified group of nurses,” says Tran. “It also allows us to hone our strength as people who are minorities, who come from rural communities or are first generation college-goers.”

Both Tran’s academic and extracurricular life have been busy. She participated in the UA Campus Health Stressbusters program, which provides students with free 5-minute back rubs, and was active in the Asian/Pacific American Medical Student Association (APAMSA). Additionally, she worked as a patient care technician at Tucson Medical Center’s Cardiac Care Unit and interned in the UA College of Pharmacy’s Medication Management Center. In May, she was presented the Mary J. Jeffries Achievement Award, which helps BSN students committed to pursuing graduate study in nursing pursue their Doctor of Nursing Practice (DNP).

“I wanted to become one of those people who support patients through the best and worst times of their lives." ~ Connie Tran

As a BSN honors student, Tran has proved herself to be adept at the rigors of research. With the support and guidance of her faculty mentors, Melissa Goldsmith, PhD, RNC, clinical associate professor, and Melanie Welch, RN, clinical instructor, she developed her thesis, “Experience of Fathers During Childbirth: Key Issues and Implications.” Her research examines interventions that hospitals and childbirth educators can implement to improve the experience of new fathers.

To students considering enrolling in the UA College of Nursing, Tran has nothing but encouragement. “It’s really tough at first and there’s a huge learning curve, but after that first semester everything will settle down,” she says. “The faculty here are really supportive and kind. Make sure you utilize them because they will be your biggest helpers, your biggest coaches and your biggest cheerleaders.”

The future looks bright for Tran after graduation. She already has a job lined up in her home state of Texas and plans to continue her education in the fall. Thanks to the support of the Mary F. Jeffries Achievement Award, Tran plans to enroll in the UA College of Nursing’s DNP program’s Family Nurse Practitioner specialty.

“As a nurse, I want to make sure I’m using evidence-based care and practices when I’m caring for my patients,” she says. “I want to make sure I’m looking at the whole person, making sure I’m dealing with every aspect of their life, including emotional, mental and physical wellbeing.”