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May 5, 2000

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Nursing Makes News During National Nurses Week May 6-12

National Nurses Week begins May 6 and ends on May 12, Florence Nightingale's birthday. The role of nursing since Nightingale's influence has changed broadly in the age of managed care and health care reform. Yet, with all the changes taking place around them, nurses continue their role as patients' strongest advocates.

Below are suggested stories from Hopkins to feature in coverage of National Nurses Week.

For many, choosing a lifetime career is a difficult and often soul-searching task. But for 25-year old Clint Burns, it was simple. As he lay in bed on Nelson 7 of The Johns Hopkins Hospital recovering from a liver transplant, he dedicated himself to giving back the care he got. "I knew I wanted to be in health care because I had been around patients all my life," says Burns, now 30 and a registered nurse -- working on Nelson 7 -- at Hopkins. "But I never imagined myself back on the same unit where I was a patient, caring for others in need of transplants and working with the same staff who cared for me." After years of treatment for familial cholestasis, a congenital liver condition, Burns had come to know the Hospital staff well. "I was so blessed to have a wonderful staff taking care of me," he says. Burns' history has inspired numerous wary transplant patients and helped bolster awareness of the importance of organ donation.

By providing critically ill cancer patients a reprieve from their prolonged, two-month hospitalization during transplant treatment, two Hopkins oncology nurse managers have transformed the care of patients with leukemias, lymphomas and other hemotologic malignancies and established a national model for outpatient peripheral blood and bone marrow transplant. Working under increasing patient dissatisfaction with the lack of continuity of health care providers during their long stay and the pressures of cost reduction from managed care, Gina Szymanski, R.N., and Jane Shivnan, R.N., introduced IPOP, an acronym for Inpatient/Outpatient continuum. The program helps patients undergoing treatment -- once an exclusively inpatient process move from the hospital to nearby homelike apartments as their medical condition warrants. "We wanted to add some normalcy to our patients' lives at such a difficult time," says Szymanski. "Being bedside nurses was essential to understanding what could be tweaked, fixed, changed." Always with patients in their apartment is their own personal caregiver - a family member or close friend trained by IPOP nurses to monitor temperatures and be an extra set of eyes and ears for the patient. The result: The average 40-day hospital stay was reduced by 30 days and the extensive cost of bone-marrow transplantation trimmed by a minimum of $20,000. Most importantly, IPOP has dramatically improved the long and life-altering experience for patients and their families.

The Hopkins name is recognized internationally for its research and patient care, but for young victims of the civil war in the Balkans it carries a special, personal meaning. During the crisis, health officials called upon Joe Capozzoli, R.N., nurse manager of the Child and Adolescent Psychiatry Unit at the Johns Hopkins Children's Center. A Hopkins nurse since 1979, Capozzoli has for years been recognized by his colleagues for his creative approach to complex care problems. Four years ago, he traveled to Croatia to help teach non-professionals ways to diagnose and treat children psychologically traumatized by the civil war. "Kids need healed minds as well as bodies," said Capozzoli. His experience in Croatia led to a book that will serve as a nursing manual on diagnosing and treating children exposed to violence.

Nursing's influence in health care is rooted in detailed knowledge of patients. Three years ago, the term "data competence" was coined by Marie T. Nolan, D.N.Sc., a nurse researcher at Hopkins Hospital. Now, Nolan is teaching other Hopkins nurses how to access, analyze and use patient data to maximum advantage. "Data competence is the key to identifying trends and problems, and guiding decision making in patient care," says Nolan. Formerly, a select few nurse researchers conducted data analysis within the confines of a research study. Recently, however, user-friendly statistical software packages have enabled a variety of health professionals to regularly analyze patient data. "Nurses in every role can benefit from these skills, but those in leadership positions are increasingly being called upon to make data-based decisions, "says Nolan. "The more data competence becomes part of nursing practice, the greater the nursing influence in health care will be in the information age." With Nolan's recent publication Managing Patient Outcomes, coauthored by nurse researcher Victoria Mock, D.N.Sc., this skill will be introduced to nurses nationwide.

Wired as never before, Hopkins nurses enter the 21st century using new technologies and cyberspace as readily as a stethoscope or syringe. "Computers weren't around 25 years ago when I began nursing," says JoAnn Coleman, R.N., A.C.N.P. Today, Coleman's personal computer links her from East Baltimore to patients around the world. Her office is the nerve center for queries and referrals for victims of pancreatic cancer and their relatives. She answers calls and routes patients to physicians or surgeons after assessment of their needs by primary care doctors. Coleman is one of hundreds of Hopkins nurses who make the Internet and other technological advances part of their daily routine. Nurses use PCs, laptops and such hand-held computers as a Palm Pilot to record patient information, inform patients about their illnesses, provide virtual tours of hospital units and recruit new colleagues. "The computer is limitless in terms of its potential," says pediatric nurse Carol Matlin, M.S., R.N. "Soon, we won't even need books on the shelves."

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For more information or to interview these or other Hopkins nurses, please contact Melissa Murray at 410-955-8668 or mmurray1@jhmi.edu or Jay Corey at 410-955-1078 or jcorey@jhmi.edu.

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