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Posts from the ‘Diana Mason’ Category

Healthstyles on December 11: Choosing Wisely and Women’s Economic Development

WBAI

There’s an old saying that “women hold up half the sky”. But around the world, women–and thus their families–are living in poverty with little access to the education that can help them to make a decent living and promote the health of their families. A longstanding international development practice has targeted investments in women’s enterprises, particularly in small businesses and agriculture. These investments have involved partnerships among public, private and philanthropic sectors. But one nurse is advocating that its time to invest in the education and work of female nurses and midwives in low income countries–and that doing so would not only be a wise investment in women’s education and economic development, but could also strengthen local health systems and reduce maternal and infant mortality.

This week’s Healthstyles program opens with producer and co-host Diana Mason, PhD, RN, FAAN, talking this nurse about her new approach to women’s economic development in low resource countries. The nurse is Marla Salmon, ScD, RN, FAAN, Professor of Nursing and Global Public health, and Senior Visiting Fellow at the Evans School of Public Affairs at the University of Washington. She is also a member of the Institute of Medicine where she has worked on developing this idea and building multi-sector support for it. You can listen to the interview here:

The second half of Healthstyles focuses on unnecessary care. The United States spent between $158 billion and $226 billion on overtreatment in 2011. This overtreatment includes unnecessary tests and procedures that can be harmful and costly. For example, pregnant women who deliver in a hospital are often put on continuous electronic monitoring of fetal heart rate ostensibly to ensure that the soon-to-be-born baby is not in distress. But the monitoring means that the laboring woman is unable to move around, which can slow down the labor, and misinterpretation of the monitoring can lead to unnecessary inducement of labor or Caesarean sections that can jeopardize the health and outcomes for both the mother and the infant.

So why do we do these unnecessary tests and procedures and how do we know what is unnecessary? Choosing Wisely is designed to help the public identify which tests and procedures should be questioned if recommended by a provider. On the second half of Healthstyles, Diana Mason discusses the problem of unnecessary care and the Choosing Wisely initiative with Daniel Wolfson, MHSA, Executive Vice President of the ABIM Foundation that developed Choosing Wisely; Karen Cox, RN, PhD, FAAN, Chief Operating Officer of Mercy Children’s Hosptial in Kansas City, MO, and the chair of the American Academy of Nursing’s Task Force for selecting nursing’s list of Choosing Wisely recommendations; and Lisa Woodward, Vice President of Nursing Education at Doctors Hospital at Rennaisance in Edinburg, Texas, and Co-leader of the South Region for the Texas Action Coalition that is involved in promoting the use of the Choosing Wisely list throughout the state.

You can listen to the segment on unnecessary care and Choosing Wisely here:

So tune in for Healthstyles on Thursday, December 11, 2014, on WBAI in New York City at 99.5 FM or online at wbai.org.

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

 

Choosing Wisely: Policy or Professional and Patient Responsibility?

choosing Wisely

My latest blog post on JAMA News Forum is on the Choosing Wisely initiative that was started by the ABIM (American Board of Internal Medicine) Foundation. The initiative identifies unnecessary and sometimes harmful and costly tests and procedures that should be eliminated or seldom done. The aim is to have physicians and patients use the lists (developed by various professional societies) to have conversations about testing and treating that can reduce unnecessary care. My JAMA blog discusses whether we need policy changes to be able to move more quickly on incorporating these discussions into care, whether through penalizing their use or incentivizing the crucial conversations about what care is necessary and safe and what care is not.

As of October, the initiative now includes the first-five list of nursing-identified unnecessary care, through work being led by the American Academy of Nursing (disclosure: I’m the Academy’s president). That list includes:

“1. Don’t automatically initiate continuous electronic fetal heart rate monitoring during labor for women without risk factors; consider intermittent auscultation first.

2. Don’t let older adults lay in bed or only get up to a chair during their hospital stay.

3. Don’t use physician restraints with an older hospitalized patient.

4. Don’t wake the patient for routine care unless the patient’s condition or care specifically requires it.

5. Don’t place or maintain a urinary catheter in a patient unless there is a specific indication to do so.”

I hope that all health care professionals and organizations will share the Choosing Wisely work with colleagues, health care organizations, and the public.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

Healthstyles on December 4th

WBAIIn 2011, Vermont became the first state in the nation to commit to a single payer system. It’s to convert to this system by 2017. And while Vermont is a small unique state, proponents of single payer systems will point out that Canada’s national health plan started by one province–Saskatchewan–reforming how it paid for care. So a lot of people are paying attention to what is going on in Vermont. This week’s Healthstyles program opens with co-producer and host Diana Mason, PhD, RN, interviewing Betty Rambur, PhD, RN, professor of Nursing and Health Policy at the University of Vermont approach to a single payer system. Dr. Rambur is one of five members of Vermont’s Green Mountain Care board, a new independent agency that will oversee the development and implementation of the single payer system. Vermont’s success or failure can inform proposals in other states that are considering adoption of a single payer system, including in New York. As you’ll see, it’s not an easy challenge.

Then Healthstyles co-producer Kenya Beard, EdD, RN, joins Diana in talking about health disparities and hypertension with Dr. Carla Boutin Foster, associate professor of medicine at Weill Cornell Medical Cllege and the Principal Investigator for the Center for Excellence in Health Disparities Research. Her research has focused on reducing health disparities in cardiovascular disease and cancer, with particular attention to the Harlem community of African Americans.

So tune into Healthstyles on Thursday, December 4, 2014, on WBAI, 99.5 FM or online at wbai.org. Or listen to the interview here:

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New Yori.

Healthstyles on Thanksgiving: Turkey Talk

WBAI

At 1:00 on Thursday, November 27th, 2014–Thanksgiving Day–radio listeners are likely to be in the kitchen or sitting at home contemplating a day alone. Regardless, WBAI and Healthstyles will keep you company.

Host Diana Mason, PhD, RN, introduces the hour’s program then suggests that those who are depressed about being alone on Thanksgiving might find comfort in joining an online chatroom called Lifeline Crisis Chat that provides online emotional support, crisis intervention, and suicide prevention services.  You can access this service by going online to www.crisischat.org. If you cannot reach a Lifeline Crisis Chat specialist onlne, you can call 1-800-273-TALK (8255). She then discusses “turkey talk”–the idea promoted by some to use the Thanksgiving gathering of family members and close friends to have crucial conversations about end-of-life wishes, including advance directives and health care proxies.  You can listen to the opening here:

Healthstyles co-producer Liz Seegert follows with an interview with Stephen Johnston, co-founder of Aging 2.0, about how technology can support a healthy lifestyle as one ages. To listen to the interview, click here:

The last half hour of the program is an interview that Diana conducted with nurse Donna Gallagher about her work over the years to build the health care and nursing workforce capacity of Liberia–efforts that are now terribly set back by the Ebola crisis in that country. Listen to the interview here:

So tune in on Thursday at 1:00 on WBAI, 99.5 FM, in New York City or online at www.wbai.org.

Heathstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

Invisible Again

invisible nurse

What’s wrong with this media advisory:

______________________________________________________________________

MEDIA ADVISORY
NIH MEDIA BRIEFING ON DISCHARGE OF EBOLA PATIENT FROM ITS CLINICAL CENTER SPECIAL CLINICAL STUDIES UNIT

WHAT
NIH officials will brief reporters about the discharge of Nina Pham, the Dallas nurse who was admitted to the NIH Clinical Center on October 16 with Ebola virus disease, and is now virus free.

WHO
— Francis S. Collins, M.D., Ph.D., Director of the National Institutes of Health
— Anthony S. Fauci, M.D., Ph.D., Director of the National Institute of Allergy and Infectious Diseases
— H. Clifford (Cliff) Lane, M.D., NIAID Clinical Director
— John I. Gallin, M.D., Director, NIH Clinical Center
— Tara Palmore, M.D., Director, Hospital Epidemiologist, NIH Clinical Center and Director, Infectious Diseases Training Program, NIAID
— Rick Davey, M.D., Deputy Clinical Director, NIAID Division of Clinical Research

___________________________________________________________________________

Once again, nurses are missing from media stories on Ebola. Why would the NIH clinical center not include at least the chief nurse for the clinical center to talk about the care that Nina Pham received?

We’re back to pre-Nina Pham days.

When nurse Nina Phan was diagnosed with Ebola, journalists were on the hunt for nurses who could be interviewed. While National Nurses United was proactive with reaching out to media, other journalists turned to nurses such as Karen Cox, Secretary of the American Academy of Nursing and COO of Mercy Children’s Hospital in Kansas City; Pamela Cipriano, president of the American Nurses Association;  and Elaine Larsen, international expert in infectious disease and professor of nursing at Columbia University. As president of the American Academy of Nursing, I was fielding multiple media requests, providing commentary on the situation and referring journalists to experts such as Cox and Larsen.

It was a ‘media frenzy’, as many called it. For nurses, it was heartening to see the attention to the daily, heroic work of many nurses and to see nurses as spokespeople in the media. But once Nina Pham was declared Ebola-free, the calls stopped. Now it’s all physicians and politicians all the time.

Of course, the exception is Kaci Hickox, the nurse who is being quarantined outside of University Hospital in Newark, NJ, after returning from Liberia where she cared for patients with Ebola. She is sympom-free and, probably Ebola-free; and, thus, not able to transmit the virus. Despite this, Governors Andrew Cuomo and Chris Christie have set policies in their states that require aid workers and other travelers from West Africa who had contact with Ebola patients to be quarantined for 21 days. This is not a house-quarantine with self-monitoring.

On CNN Sunday morning in an interview with Candy Crowley, Hickox refused to agree that the policies were reasonable. Instead, she argued that the policies do not reflect the available evidence. Indeed, as another CNN reporter pointed out, the nurses and other health care workers who are taking care of patients with active Ebola in Bellevue Hospital, demonstrating how poorly thought out the policy is. Hickox was informed, smart, and fiesty. She stood her ground and clearly articulated her reasons for opposing the new quarantine policy.

Once Hickox is able to go home, will there be any nurses’ voices in the media’s discussion of the nation’s response to Ebola and other infectious diseases? Will nurses be sought routinely by journalists as experts on health and health care issues? Will their different and important perspectives on these matters be sought?

Or will we once again be invisible?

Diana J. Mason, PhD, RN, FAAN, Rubin Professor of Nursing

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