Wednesday, November 1, 2017

What's It Like to Be a Parish Nurse?

What's It Like to Be a Parish Nurse?

Jacqueline H. Walker, RN, BSN, LTC(R)
August 24, 2017

From the Army to the Church

I like being able to help others, assist them in becoming self-sufficient, and give them information on preventing health issues and maintaining a healthy lifestyle within my church community.
Figure 1. Jacqueline H. Walker, BSN, LTC(R), RN. Courtesy of Jacqueline Walker.
Over the course of my nursing career, which spans 45 years, I have worked at numerous hospitals and military installations in the United States and abroad. I have even earned the honor and the privilege of retiring as a nurse in the United States Army with a rank of Lt. Colonel. However, my most rewarding nursing experiences are attributed to my role as parish (or faith community) nurse.

 What Is Parish Nursing?

According to the Westberg Institute for Faith Community Nursing:
Faith community nurses are licensed, registered nurses who practice holistic health for self, individuals and the community using nursing knowledge combined with spiritual care. They function in paid and unpaid positions as members of the pastoral team in a variety of religious faiths, cultures, and countries. The focus of their work is on the intentional care of the spirit, assisting the members of the faith community to maintain and/or regain wholeness in body, mind, and spirit.
I've been the parish nurse at Trinity Baptist Church in Birmingham, Alabama, since February 2016 (Figure 2).
Figure 2. Jacqueline in front of the church where she serves as parish nurse. Courtesy of Jacqueline Walker.
I have been doing nursing in my church for much longer, but the title has made it more formal. (Parish nurses have a well-defined role, with scope and standards of practice outlined by the American Nurses Association.) I provide services according to the needs of the congregation. We work with the Congregational Health Program at Samford University and the Brookwood Baptist Medical Center. I set the goals for the Health Ministry, and I report to the pastor of my church to discuss the activities I have planned for each month and what I will need to accomplish our goals. To determine the health needs of the congregation, I conducted a survey and identified their top health concerns (exercise and health, weight control, arthritis, hypertension, diabetes, and the relationship between faith and health).
I am autonomous in deciding how I spend my time, and my hours vary. Although I am a senior now, I continue to teach classes on health and spirituality. I provide educational materials to the members of the congregation and I coordinate health fairs every 2 years. I also assist other organizations with their health and wellness programs. I lead support groups and encourage participation in charity walks. I also lead a group of nurses, laypersons, and a doctor to assist in rapid response in medical emergencies while at church. Although I am a volunteer, I maintain my RN license and carry malpractice insurance.

My 'Patients'

Figure 3. One of Jacqueline's roles is to provide health educational materials to the congregation. Courtesy of Jacqueline Walker.
As a parish nurse, my "patients" are the members of the congregation of a church that I have attended since I was 12 years old. My interest in the health of church members is long-standing. I remember, while in my twenties, working with my most memorable senior group at the church—a group that helped me realize that I would be in the helping profession for the rest of my life. Many of the seniors called me "Nurse" when they didn't recall my name. However, they knew that if they had a health concern, they could depend on me to explain what was happening and share the necessary steps to feel better or seek the appropriate medical intervention.

We would meet at the church on Monday mornings in the gym and have devotion, which consisted of a song, a prayer, and a Bible verse. We walked all around Bush Hills, a main thoroughfare near the church. At the end of one of these walks, I remember that one of my members would have to take a few moments to catch her breath before talking with me. For a long time, no matter when I would return from an active-duty tour, she would always inform me that she was still walking. Maintaining this type of community connection is a very important aspect of parish nursing.
My pastor at that time established a group called "Healthy Breakfast and Exercise for Seniors." I was given the responsibility of presenting them with a topic on spirituality and health each week. I enjoyed seeing their faces light up when they were able to answer a question. I admired the determination they demonstrated during the CPR course I led. Some could no longer blow hard enough to make the chest rise or push hard enough to hear the click on the manikin. However, in their faces, I could see their will to persevere, and most of them eventually completed the course successfully. These seniors had so much to share, so many stories to tell. They strived for a purpose every day, something to make them get out of bed. Even today, I am heartened when I can help church members of any age feel empowered to take control of their health.

The Challenges of Parish Nursing

The work of a parish nurse can be challenging, however. Sometimes there are not enough human and material resources to accomplish our goals. Sometimes, on the day of an event, there is simply not enough help. However, I always find joy in seeing other people smile and I am fulfilled when I am being of service. For me, if a church member learns at least one thing to make his or her quality of life better, then the sacrifice of my time and talent is worth it.
Many people have found that it isn't always easy to pray with someone who is dying, hurting, or suffering. As parish nurses, we learn that it is OK to be silent and the importance of touch.

Jacqueline Walker would like to acknowledge the assistance of Tonya Williams-Walker in the preparation of this article.

Sunday, October 1, 2017

Treating sepsis with vitamin C

Treating sepsis with vitamin C
Could vitamin C help treat sepsis? Some medical experts in Norfolk, Virginia, think so.
A recent study from Eastern Virginia Medical School saw surprising success with a treatment plan combining vitamin C with steroids. The outcomes were so stunning that the National Institutes of Health (NIH) gave the researcher $3.2 million to dig in a little deeper.
Sepsis, a condition caused by infection, is responsible for 258,000 deaths each year. Seniors and babies are at greatest risk. Symptoms range from shivering and fever to breathlessness and confusion. If untreated, it could lead to septic shock or death.
Ordinarily, sepsis is treated with IV fluids, antibiotics, vasopressors or steroids. The Eastern Virginia study found that the effectiveness of steroids improved when combined with high doses of intravenous vitamin C. It’s a revelation that shot ripples of hope through medical communities worldwide.
“This study is very new,” says Dr. Joseph Bellezzo, chair of emergency medicine at Sharp Memorial Hospital, noting that the doctor behind the study is well-regarded in medical circles and that new clinical trials may begin as a result of his work.
Given in very high doses, vitamin C can have negative effects — some as extreme as renal failure. But according to Bellezzo, “Vitamin C in doses suggested by the study has no negative impact at all. And unlike previous treatment trends, the cost is close to nothing.” So the question now is: What’s the harm in trying?
“Sepsis patients are very vitamin-depleted,” says Dr. Bellezzo. “Knowing this, and knowing that vitamin C does no harm, and weighing the success of the study, it seems like something we should be actively looking at.”
As an ER physician, Dr. Bellezo can’t administer vitamin C unless his ICU counterparts continue the treatment post-ER. So he plans to work with them on establishing a protocol. “I want to test it out and measure outcomes,” he says. “It can only help the patient, not harm them.”
But Ashkan Khabazian, PharmD, a pharmacist at Sharp Memorial Hospital, is reluctant to call it a cure. He’s seen trends like this one rise (and fall) before, and sees a need for more thorough, in-depth research. “I’m not saying we should rule it out,” says Khabazian, “because vitamin C has benefits. But one single-center study isn’t enough to completely change our practice.”
When taken orally, vitamin C doesn’t have much effect on the body; but administered intravenously, it can. By protecting the lining of your blood vessels and assisting chemicals that force your blood vessels to “squeeze,” vitamin C can play a role in improving blood flow to the vital organs — a key element in the treatment of sepsis. Its role in clinical bedside medicine has been under-examined, and it hasn’t been a major player since treating scurvy back in the day.
Although some hospitals are trying the protocol, Khabazian would like to see larger, randomized, controlled multi-center trials confirm the benefit found in the initial study before making vitamin C a regular part of sepsis treatment at Sharp.
We may have a ways to go before vitamin C shows its true value. But if proven successful, it will be worth the wait. A treatment that’s low-risk, low-cost and effective? Seems too good to be true. And it just may be. But like any new medical breakthrough, we need to start somewhere.

Friday, September 15, 2017

Community Service Match

Gamma Gamma Members
Our chapter has chosen hurricane relief as our 2017 Community Service Participation Award.
The board voted $1000 in matching funds and we are doing this through a local San Diego 501C agency.
International Relief Teams has a 30 year history of responding to disasters both national and international and has received the prestigious 4 Star Charity Award for 14 consecutive years.
Go to their website International Relief Teams and check them out.
If you are able to assist at this time, however much,
mark GAMMA GAMMA in the "how did you hear" box on the donation form.
You will receive an instant tax donation receipt before you log off the site.
And in December we will receive a total for the chapter matching funds check.
Thank you in advance for your support.

Friday, September 1, 2017

What does a hospital chaplain do?

What does a hospital chaplain do?
April 5, 2017
What does a hospital chaplain do?
Chaplain Judy Ray and her colleagues provide more than just spiritual care for patients and visitors at Sharp Grossmont Hospital.
Today’s hospital chaplains provide spiritual and emotional support to patients and staff in ways that bear little resemblance to the chaplains of years past.
Previously, chaplains were traditionally white, male and Protestant. But today’s spiritual care providers come from backgrounds that are as diverse as the patients they serve, and their responsibilities encompass so much more than just pastoral support.
Sharp Grossmont Hospital Chaplain Judy Ray personifies this new generation of clergy. She received her bachelor’s degree in psychology, and was ordained as an interfaith minister, which positions her well to care for the hospital’s diverse patient population.
The responsibilities of a chaplain run the gamut. At the heart of their work, they are purveyors of comfort, compassion and spiritual enlightenment. They minister in times of grief as well as celebrate in moments of joy.
At Sharp Grossmont, Chaplain Judy (as she prefers to be called) and her colleagues make daily rounds in the Emergency Department and throughout the clinical care areas to assist patients in need.
Spiritual care providers offer the following services:
  • Spiritual support and counseling for patients, visitors and staff
  • Daily communion from Eucharistic ministers
  • End-of-life and grief support
  • Spiritual literature and resources
  • Critical incident stress debriefing
  • Prayer, meditation and music
Chaplains also have strong ties to faith leaders within the community, and facilitate visits with Catholic priests, rabbis and imams. “We provide resources to all the major faith traditions in the community,” says Ray.
It takes a village
Providing support to a large hospital is beyond the scope of a small team, so Ray relies on volunteers for an extra layer of help. More than 35 specially trained volunteers at Sharp Grossmont provide comfort and companionship to the dying and their families in the final days of life, as part of the hospital’s unique “11th Hour Program.” To celebrate life’s new beginnings, Ray initiated a popular service called Baby Blessings, for newborns and their parents.
During her career at Sharp Grossmont, Ray has provided compassionate support to thousands of patients and their loved ones in need. When asked if there are any experiences that stand out in her memory, she speaks about the time she sat with an elderly couple while the wife lay dying and her husband reminisced about their 65 years together.
“I was able to bring comfort and listen with compassion,” says Ray. When his wife passed, the husband told Ray, “I’m OK now, because you were my angel.”
Comfort and mindfulness
Ray also recalls the time when she comforted a young mother in the ER, who experienced an unspeakable tragedy when her two young children accidentally drowned. Ray sat with the mother for hours, while supporting the physicians, nurses and staff affected by the incident.
“What helped me get through this was my mindfulness practice. I had to stay focused and balanced, and take care of myself while I was taking care of others,” she says.
More chaplains like Ray are incorporating the practice of mindfulness in their work, which has been shown to help reduce stress, lower chronic pain and improve concentration, among other benefits. In today’s fast-paced and highly charged health care landscape, mindfulness is like a welcome and calming ocean wave.
Ray leads Monday mindfulness sessions for staff, as well as ongoing series of more in-depth classes.
“Our focus has changed in recent years, in terms of taking care of staff. If we can take better care of ourselves, we are prepared to take better care of our patients,” she says.

Tuesday, August 1, 2017

Staying healthy when others are sick

Staying healthy when others are sick
April 5, 2017

It can seem to be a never-ending cycle. First one person in your home gets sick with a cold or flu — perhaps your school-aged child, partner or roommate. Then you start feeling that slight tickle at the back of your throat or mild ache near your temples, and you sense that you’re next in line for the illness.

During the cold and flu season, staying healthy when others around you are not sometimes feels like an impossible goal.

According to Dr. James Lin, a board-certified internal medicine doctor with Sharp Rees-Stealy Medical Group, there are steps you can take to avoid being the next victim of whatever virus may be taking up residence in your home. These are his top five tips for staying healthy when others are sick:

Stock up
Before heading to the store, make sure you have appropriate over-the-counter medications, healthy foods your loved one can eat, tissues, hand sanitizer, juices and sports drinks to ensure everyone stays hydrated. Don’t forget to add disinfecting cleaning products to your shopping list.

Love from afar
Try to encourage the sufferer to stay in their bedroom. Make sure they have things to read and watch (if they are able), and that they get lots of rest. Keep the bedside table well-stocked with fluids throughout the day, tissues and a trash can to dispose of the used ones. If it’s not too cold outside, crack a window to let fresh air in the house. Keeping your under-the-weather housemate semi-secluded minimizes the spread of sickness.

Keep it clean
Disinfect the things touched by sick hands. This includes door and refrigerator handles; kitchen and bathroom countertops and sink handles; cabinet and drawer pulls; computer and TV components; remotes; and telephones. Wash towels, sheets, blankets and pillowcases often during the illness and before anyone else uses them.

Care, but don’t share
Sharing may be caring, but not when it’s a bug. Make sure that anything an unwell person has used is washed before someone else takes a turn. This includes towels, pillows, utensils, cups and toys. You might want to consider throwing out things that are easily replaced, such as pens, pencils, crayons and bars of soap. It also wouldn’t hurt to toss and replace everyone’s toothbrush.

Wash your hands!
Make sure everyone in the household — both sick and well — is washing their hands often with soap and water, and refraining from touching their eyes, noses and mouths. Also, remind your sick housemate to cough and sneeze into their elbow.

“Don’t forget to take care of yourself when taking care of someone who is sick,” says Dr. Lin. “Make sure you eat a diet rich in fruits and vegetables, practice good hygiene, exercise and get enough sleep — all things that can boost your immune system and help keep you well.”


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Saturday, July 1, 2017

How Often Should You Change Your Sheets?

How often should you change your sheets?

March 30, 2017
On average, we spend one-third of our lives in bed. So frequent sheet cleaning seems like a no-brainer. But some bedding, like your mattress pad or comforter cover, could skip a few loads. We stripped your bed (no, not literally) to see how often you really need to clean it.


Cleaning frequency
We shed skin cells, sweat and oil every night. Keep your sleep space clean, and avoid dust mites, by washing your sheets once a week. If anyone in your household is sick, wash sheets (or at least the pillowcases) daily.
Cleaning instructions
Use the hot water option on your washing machine, and the hot cycle on your dryer. This will help kill germs, although it could shrink your sheet's fibers.


Cleaning frequency
Pillow stuffing can attract allergy-causing dust mites, so they should be washed a few times throughout the year.
Cleaning instructions
Check your pillow's label — most down and synthetic varieties are machine-washable. Use the gentle cycle, hot water and liquid detergent. Wash two pillows at the same time for balance, and put them through the rinse cycle twice. To dry, use the low setting on your dryer, and add two clean tennis balls to avoid flattening.

Pillow and mattress protectors

Cleaning frequency
Pillow and mattress protectors extend the life of your bedding, and help ward off dust mites. Even though they're covered by sheets and pillowcases, you should still wash your protectors once a month — especially if you have allergies or a pet.
Cleaning instructions
Covers and pads can have a variety of washing options, so check the label. But in general, most can be machine-washed in warm water, and dried on the low setting.

Comforter covers

Cleaning frequency
If you're washing your comforter cover as frequently as your sheets, you may be washing it too much. If you don't use a top sheet, then yes, wash the cover once a week. But if you do use a top sheet, wash your comforter cover once a month.
Cleaning instructions
As a general rule, wash your comforter cover the same way you wash your sheets — with hot water and a hot dryer. If your cover is decorative and you're worried about shrinking, use lower temperatures and detergents meant for delicates.


Cleaning frequency
As long as your comforter has a cover, you shouldn't have to wash it as often as your sheets. Instead, wash it a few times a year — as frequently as you should be washing your pillows. Without a cover, your comforter needs more cleaning. Wash it once a week if you don't use a top sheet, and once a month if you do.
Cleaning instructions
Not all comforters are built the same, so check the label. Otherwise, your washing machine — as long as it has a large enough capacity — should do the trick. Wash on the gentle or delicate cycle using warm, not hot, water. Dry it on low heat with a few clean tennis balls to plump it up.
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Thursday, June 1, 2017

The Three E’s Of The Nurse Commitment

The Three E’s Of The Nurse Commitment

The Three E's of the Nurse Commitment
Deciding to become a nurse is more than a career decision, it’s a decision about the way you’re going to approach life in general. The nurse commitment starts when you first enroll in undergrad classes toward your nursing degree, and it continues throughout your career through retirement and beyond.
The nurse commitment can be broken down into the “three E’s”: education, endurance, and empathy. Nurses are some of the most educated professionals, undergoing ongoing training and personal career development throughout most of our lives. Like the physicians we work alongside, we have extensive education and training in the biomedical sciences, including both theoretical knowledge about the workings of the human body, and hands-on practical training in administering healthcare.
We also have endurance in spades. Nursing is a profession that is mentally, emotionally, and physically demanding. Between twelve-hour night shifts, life-or-death decision making about patient care, and the emotional experience of caring for a patient and eventually losing them to their age or illness, we deal with a lot of mental and emotional stress. That takes endurance and a lot of it.
Finally, there’s also empathy. Nurses are caregivers by nature. We’re healers, people who tend to the sick and injured. We work closely with the patients we care for, cultivating a therapeutic relationship that provides emotional and medical support on their road to recovery. To be a nurse, you must have empathy. It’s not a job that’s well suited to people who are impersonal and cold.

Nurses are highly educated professionals, and most have at least a bachelor’s degree. Ongoing education is a central aspect of a career in nursing. As medical techniques and technology grow and evolve, nurses need to remain up to date with the latest new developments.
Many nurses choose to further their education partway through their career. Nurses with bachelor’s degrees often end up pursuing a master’s, and some even go as far as obtaining their PhD.

Continuing Education
There are a wealth of courses available for working nurses to continue expanding their knowledge and skill sets. Many nurses choose to pursue additional credentialing in specialized areas of nursing. The American Nurses Credentialing Center offers numerous certifications and certification renewals in a variety of areas, including (but not limited to):

  • Nurse practitioner certifications in areas like psychiatric nursing, gerontological nursing, and family practice.
  • Clinical nurse specialist certifications in areas like pediatrics, psychiatry, and gerontology.
  • Specialty certifications in areas like home health nursing, school nursing, diabetes management, community health, psychiatry, pediatrics, and mental health.

Conferences & Seminars
There are also many conferences and seminars in which nurses can participate to gain new insight into the latest new developments in the world of nursing. Many are available as webinars, meaning you don’t have to travel to participate in them. The American Nurses Association (ANA) maintains a list of upcoming conferences and webinars here.

Nurses also need a whole lot of endurance — mental, physical, and emotional. Nursing is surprisingly physically demanding, keeping us on our feet all day and moving around from place to place. We also do things like help patients from their bed into a wheelchair, which require physical strength.
Nursing is also mentally demanding. We need to make fast, accurate, informed decisions about the course of patients’ ongoing care, and in some cases, those decisions are life or death. Many of us are in leadership positions, where we also need to make decisions for our entire teams.
And then, there’s emotional endurance. We have to stay upbeat, friendly, and positive, putting our patients at ease even if we ourselves are literally having the worst day ever. And then, there’s the experience of losing a patient. Many of us, especially those of us in specialties like gerontology and oncology, have cultivated strong therapeutic relationships with patients who we ultimately lost. All of these things take emotional endurance, the form of endurance that nurses need that’s probably the least talked about.

Nursing requires empathy. This isn’t a profession for cold, mechanical people who don’t get along well with others. We have to be able to really understand what our patients are going through, mentally, physically, and emotionally, so that we can provide the best possible quality of care. Many of us work with challenging populations that can make this even more difficult, like patients with severe dementia or with disabling degrees of mental illness.

Embracing the Three E’s
As nurses, we embrace the three E’s as part of our role in patient care. We’re strong people, with endurance that others can only dream of. We’re educated to a level far beyond many other types of white-collar workers. And, most importantly, we cultivate empathy and compassion.
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