Alumna Rolls Up Sleeves at Uganda Hospital

Meg Zomorodi, BSN ’01, PhD ’09, went to Uganda last summer as part of a medical mission organized by Duke University Medical Center. She and her team worked in Mulago Hospital — the hospital where several scenes from The Last King of Scotland were filmed. She plans to return this summer with several SON students to continue the work she helped start.

This is what she had to say about her experience:

I’ve always wanted to participate in a medical mission trip so when Michael Haglund, M.D., a neurosurgeon at Duke University Medical Center approached me about going to Uganda for two weeks, I didn’t hesitate.

Without knowing any specifics, my husband and I agreed to be a part of this 28-person medical team, determined to make a difference in the lives of the Ugandan people. We had no idea the impact that Uganda would make on our lives and how determined we would both become to maintain a continued relationship with this beautiful country.

What started out as a mission trip to conduct medical services for the people of Uganda grew into a massive undertaking. In January 2007, Haglund traveled to Uganda to tour the operating facilities at Mulago Hospital. What he found there was a flashback to the 1960′s where physicians operated with ether and the operating room nurse was the true canary in the coal mine – when the nurse passed out from the ether fumes, surgeries stopped for the day.

There was one ventilator in the 1,500-bed hospital, and it was only used for new admissions. Therefore, if a patient came into the hospital and the ventilator was being used, the family of the patient using the ventilator had to decide to withdraw life support or manually ventilate the patient. After this experience, our plan shifted to include donating medical equipment. When all was said and done, nine tons of equipment were donated to Mulago Hospital. With help from UNC-Chapel Hill School of Nursing (SON) faculty and students, more than 100 textbooks were donated as well. This was especially important to me since education was my top priority.

When we arrived in Kampala, word had spread about the U.S. medical mission and more than 100 people had driven across the country to have access to this free service. We unloaded the equipment and spent 12 hours unpacking and organizing our supplies.

The next morning we began our first cases. When we realized we didn’t have a phone or any way to stay in touch with the operating room, I donned a mask and ran back and forth between the three operating rooms in order to maintain contact between them and the recovery room. During the four and a half days in the operating room, we successfully completed 30 neurosurgical cases. Just as importantly, the intensive care unit and recovery rooms were completely revamped, and the nurses gained a wealth of education.

When I first arrived in the recovery room, I met Agnes, the only recovery room nurse. She told me her role was to make sure that the patient was still breathing and, then, send him or her to the floor where the nurse-to-patient ratio was 1-to-50! After unpacking our equipment, I provided information on assessment and post-op recovery, and my audience grew everyday. By the end of the week, we had a full time recovery room staff of eight nurses who performed full head-to-toe assessments, monitored vital signs for two hours, and, then, determined when, and if, the patient was stable enough to be discharged out of the recovery room.

The chief nurse told me on our last day in Mulago that theses nurses had now been hired to the recovery room, and their plan was to transform the recovery room into an overflow intensive care unit. I also spoke with her about continuing my relationship with Uganda and made a promise to her that I would never forget the wonderful nurses at Mulago Hospital.

I am doing my best to complete this promise as a representative of the SON. This summer five junior BSN nursing students will travel to Mulago Hospital as part of their summer work experience. Three (Sarah Day Dickson, Jenna Woodruff, and Jamie Cash) are planning to stay for a full three months, and the other two (Alison Helmink and Kristen Poe) will travel back with me in July. This is hopefully just the beginning of a continuous relationship with this wonderful country. For those interested in reading or supporting this experience, please visit the official blog space at: http://dukeinuganda.blogspot.com/.

Faculty researcher Diane Berry Interviewed by Orlando Sentinel

Weight loss, and type 2 diabetes and cardiovascular disease prevention

Diane Berry, PhD, CANP, assistant professor at UNC Chapel Hill School of Nursing, was quoted in an Orlando Sentinel article on motivation to lose weight. Berry focuses her research on both behavior and physiology, working with Black, Latino, and White children and parents to manage their weight and prevent type 2 diabetes and cardiovascular disease. Here is an excerpt from the article that quotes Berry:

“‘Many people are concerned about their weight, but people who successfully lose weight often experience a personal intersection, ‘ says Diane Berry. Often, she says, the one defining moment, their tipping point, is the accumulation of many experiences, from humiliations, embarrassments or frightening medical news. In a study of 20 women who had lost 10 percent of their body weight and kept it off for a year, Berry found that most of the women experienced a defining moment that led them to lose weight. For some, it was someone’s critical comment about their appearance; for others it was stepping on a scale and being shocked at their weight or buying a larger dress size.”

You can read the full article at http://www.orlandosentinel.com/features/lifestyle/orl-tippingpoint08feb26,0,7415239.story

Carolina Blue Shines at Southern Nursing Research Society Meeting

Carolina Blue were strong in number and accomplishments at the recent Southern Nursing Research Society meeting held in Birmingham, Ala. Participants from the University of North Carolina at Chapel Hill School of Nursing included seven faculty (six presented papers), two post-doctoral students (both had papers), 18 doctoral students (19 had posters) and six undergraduate students participating in the Center for Innovation in Health Disparities Research: Research Experience and Apprenticeship Program (REAP) for minority students (five had posters). Our group was diverse in gender and ethnicity/culture!!

While the quality of all of our scholars was outstanding (non-biased comments from many of the attendees), several received particular attention of the planning committee. Drs. Debra Barksdale and Margaret S. Miles’ abstracts were chosen from among all submissions to be presented at a special plenary session on health disparities. Debra’s paper was on “Stress, John Henryism and Cortisol Responses in Black Women.” Marge’s paper was on “Process Evaluation in Intervention Research: The Nurse Parent Support Intervention with Rural African American Mothers of Pre-term Infants.”

Clarence Byrd, an undergraduate REAP student, won second place in the student poster awards, competing with doctoral and post-doctoral student posters (his co-author and mentor was Dr. Debra Barksdale). His poster focused on “Body Mass Index and Weight Perceptions of Pre-Hypertensive and Hypertensive Black Americans.”

An additional honor was that the first Margaret S. Miles parent-child student poster award was given to a doctoral student from the University of Louisville.

If you are interested in research and didn’t attend this year, please consider attending next year – the conference will be in Baltimore! We came away feeling very proud of UNC-Chapel Hill SON faculty and students.

18 Donors Gift $4,300: Katrina Relief Trip a “GO”

Thanks to the generosity of 18 alumni and friends of the School of Nursing (SON) who responded to our call for help, Carolina student and faculty volunteers will climb on the bus headed for the Mississippi Gulf Coast on March 9. Over the course of the week working in Biloxi and Purlington, they will rehabilitate dwellings, conduct health assessment surveys, and assist with health care needs of the elderly and other at-risk populations. The group, representing the Schools of Nursing, Public Health and Social Work, will return to Chapel Hill on March 15. This is the third and final year for the Katrina Relief Service Trip, which has made a substantial impact on the lives of many survivors.

Donors to the SON’s Community Partnerships and Practice Fund to make this trip possible are Paul Chused, Valerie Ann Stafford-Fox, Alpha Alpha Chapter/Sigma Theta Tau, Inc., Linda Trembath Reeder, Harriet Walker Buss, Jo-Anne Trowbridge Martin, Diane Snakenburg Gordon, Anonymous, Sharon Hill Price, Rebecca Dodson, Margaret McCain, Ann Marie Polk, Melissa Dixon LeVine, Carolyn Cook Spalding, Denise Taylor Darden, Shelby Dunivant, Anne Fishel, and Nancy B. Freeman. Individual gifts ranged from $25 to $1,000, demonstrating how important grass roots support can be.

“Human Caring” conference supported by health care systems.

Health care systems are focusing their attention on ways to provide highest quality, patient-centered care in a complex medical environment. To achieve magnet status or to become a Planetree health care system is not only good for patients and their families, it is good for business. Consumers are paying closer attention as to which hospitals have the commitment to providing a caring environment and will travel, if necessary, to make these choices.

Novant HealthCare/Forsyth Medical Center, a Source of Caring sponsor for the April 2008 International Human Caring Conference in Chapel Hill, has such a commitment, which is why they are participating. So does Carolinas Healthcare System in Charlotte, a Hands of Caring sponsor. They join UNC Healthcare, the major co-sponsor of the conference along with UNC-Chapel Hill School of Nursing. Other sponsors are Alpha Alpha Chapter of Sigma Theta Tau Nursing Honor Society, Florida Atlantic University, and Kindred Healthcare.

You can get the entire conference program at: http://nursing.unc.edu/iahc

There will be more than 70 presentations and 20 posters that focus on topics such as religion, spirituality, and end-of-life; theory, ethics and aesthetics; and practice and systems. Research about human caring outcomes, as well a keynote addresses by major thought leaders from around the world will inspire, excite and give practical information that attendees can take back to their work environment.

Some specific presentations are about fostering compassionate patient care, integrative healing modalities, postpartum depression, therapeutic touch, critical care nursing, healing for obesity, heart failure and other chronic illnesses, international nursing, caring and burnout, job satisfaction and organizational support, developing a theory of healing through touch.

While the conference is centered around nursing practice, many of the presenters come from other related fields, such as social work and psychology.

Conference sponsorships at several levels are still available.

9,120 Pieces of Trident Chewing Gum Gifted for Breast Cancer Research Study

Cadbury Adams, the manufacturers of Trident Gum, made a gift of 31 boxes of Trident Original flavor — that’s 9,120 pieces of gum — to help nursing researchers at the University of North Carolina at Chapel Hill School of Nursing understand more about managing uncertainty in younger breast cancer survivors. “The chewing gum is necessary for the cortisol collection part of the study,” said Merle Mishel, PhD, RN, FAAN, the principal investigator for the National Institute of Nursing Research study. “Chewing gum helps subjects produce saliva for the samples.”

Why are samples of cortisol needed? Individuals under chronic stress have been shown to have decreased cortisol reactivity which is related to adverse health outcomes. The Carolina SON research team is studying how the fear of recurrence for younger breast cancer survivors results in a pervasive sense of a less controllable world, thereby, potentially increasing their uncertainty about cancer recurrence, which may constitute a form of chronic stress.  Chronic stress is known to weaken the immune system.

About 178,500 women in the United States were diagnosed with breast cancer in 2007; of this group, approximately 25 percent will be under 50 years of age. In the first four years following treatment, pre-menopausal women under 50 have a high recurrence rate and an increased likelihood of a second primary tumor. Uncertainty about how to interpret and handle symptoms leads to excessive worry, avoidance of symptoms or somatic vigilance. There has been little research on young survivors during the period of extended survival. Therefore, it is important to test interventions to help these women control their symptoms and manage the uncertainty about recurrence, and improve their quality of life.

There is some evidence that the impact of a breast cancer diagnosis is greater on African-American survivors and they experience more energy loss, sensory and sleep problems, pain and mental distress. African-American breast cancer survivors have rarely been included in intervention studies. This study, however, includes a significant sample of this group.

The Managing Uncertainty in Cancer Patients (MUIC) team has designed and tested a succesful intervention for older breast cancer survivors (mean 64 years of age) who were 5-9 years post treatment. This is currently being distributed by the National Cancer Institute as a model intervention program. The link is: http://rtips.cancer.gov/rtips/rtips_details.do?programid=82&topicid=12&co=n&cg=

The link will go to “RTIPs Program Use Agreement.” Please click accept button below to continue. Click on the “Product” image to download documents or to order a CD.

Most pre-menopausal women also experience an intense reponse to treatment induced premature menopause, including debilitating hot flashes, mood and sleep impairment, memory impairment, sexual dysfunction, and fatigue, yet little information from physicians is offered to help them with these treatment issues. The nursing intervention developed by MUIC places a greater focus on calming self-statements and cognitive restructuring to enhance the benefits of the intervention, which can be practiced by women on their own at home, with a self-help guide manual that can be used on as as-needed basis.

Message to New Grads: Let Your Carolina Heart and Mind Distinguish You

I was fortunate enough to help organize a panel of recent UNC SON graduates to speak to current students on the topic of transition into practice. The alums had great insights and I wanted to share a few from one panelist and UNC SON Alumni Board member, Liz Bell

Elizabeth Bell, accelerated BSN program graduate, August 2005, says

When you graduate from Carolina you will be faced with a challenging and exciting new role as a nurse in the hospital. Remember several important things when you get out into the field.

1. Remember where you came from….Carolina. Those nights you spent studying instead of doing something else were worth it. The experiences you had as a Carolina student should remain with you always. You worked hard for your degree and your new license. Be proud of yourself! However, this is not something you should use to compare yourself to others–let your Carolina heart and brain distinguish you in the field. BSN graduates (like myself) like to feel as though they have something more special than the colleague next to them with a two-year degree or a hospital diploma. Boy, did that attitude get me nowhere. More on that later if you are interested…. Anyway, we are all nurses with a common goal–to care for patients. Those others are the very nurses who are going to bring you along and teach you important skills. That first day, your BSN degree can’t even get you a cup of coffee–but it will pay off in the long run, I promise.

2. You will have good days and not so good days. If you have a question or concern, bring it up. If something doesn’t feel right during a hard day, don’t do it! There is always someone who will listen if you need help as a new graduate.

3. You are part of a team, which involves everyone from the person who takes out the trash to the highest person on the totem pole. While this is common sense, sometimes nurses forget how critical they are in rounds and in patient decision making. Be nice to everyone. Help the person who takes out the trash, and ask them how they are doing. You see them everyday. Be present. Make your opinions and your questions known. Represent us well out there!

4. Be a part of the solution. If the nurses I knew spent as much time creating solutions through positive thinking as they did complaining, we could solve the healthcare crisis. I have complained, too–but I have also decided to start acting like I want solutions. Please join your professional organization, NC Nurses Association. Vote. Stand up for what you believe in. Join hospital committees.

5. Look after yourself. We cannot be good nurses if we don’t take care of ourselves. I forgot to eat right and exercise the first year I was a nurse. I don’t blame myself, because I was trying to figure out how to survive swing shifts. Just remember that you and your people (whoever they are) are just as important as the patients you are caring for. Remember to drink plenty of water and go to the bathroom when you need to, no matter how busy the shift is that you are working. You are worth it!

I wish you all the best of luck. I am so proud to be a nurse and so proud of my Carolina education. If you need someone to talk to after a rough day or about jobs or life in general, you can email me.

This panel reminded me yet again what wonderful resources our alumni continue to be in the life of our school.

International Asian Students Chosen for National Nurse Program

Four international Asian students — Yeonmi Hu, Jinhee Park, Geongok Logan and Hanping Song — have been selected for the National Coalition of Ethnic Minority Nurses Association’s (NCEMNA) mentor/mentee program. The program is funded by the National Institutes of Health to increase the number of minority nurse researchers. Along with faculty member SeonAe Yeo, RNC, PhD, FAAN, they will attend the NCEMNA’s annual conference in San Diego in March. During the three-day conference, they will meet other minority scholars, learn professional leadership skills, have access to career developments, find future collaborators and network with other international Asian students.

Challenge Match to Support Katrina Relief Trip

Anonymous Donor Will Match Gifts to Support Student Trip to MS Gulf Coast:

$1,500 Still Needed for Students to Go

 

The gap is closing, but we are still $1,500 short of making our $4,300 goal to fund the spring break trip for nursing, social work and public health students who want to volunteer for Katrina Hurricane relief at the Mississippi Gulf Coast.

 

We just received a phone call from an anonymous donor who will match dollar for dollar every gift made to fund this trip, from $25 to $250.  Make a gift of $25 and the donor will, too.  Make a gift of $250 and the donor will, too.  All gifts must be received in the School of Nursing’s Office of Advancement BY FEBRUARY 20 to qualify for the match.

 

Make your check payable to SON Foundation, Inc., note in the memo line that it is for Katrina Relief, and mail it to:  Norma Hawthorne, UNC Chapel Hill School of Nursing, CB 7460, Chapel Hill, NC 27599-7460.

 

You have our sincerest thanks!

A Need for Chewing Gum and Breast Cancer Research: Why?

Managing Uncertainty in Cancer Patients (MUIC)and Breast Cancer: A Successful Nursing Intervention A Need for Chewing Gum to Further the Research Study. About 178,500 women in the United States were diagnosed with breast cancer in 2007; of this group, approximately 25 percent will be under 50 years of age. In the first four years following treatment, pre-menopausal women under 50 have a high recurrence rate and an increased likelihood of a second primary tumor. The fear of recurrence for younger breast cancer survivors results in a pervasive sense of a less controllable world. Indeed, the frequent and unpredictable intrusion of thoughts of uncertainty about cancer recurrence may constitute a form of chronic stress. Individuals under chronic stress have been shown to have decreased cortisol reactivity which is related to adverse health outcomes. Most pre-menopausal women also experience an intense response to treatment-induced premature menopause, including debilitating hot flashes, mood and sleep impairment, memory impairment, sexual dysfunction, and fatigue, yet little information from physicians is offered to help them with these treatment issues. Uncertainty about how to interpret and handle symptoms leads to excessive worry, avoidance of symptoms or somatic vigilance. There has been little research on young survivors during the period of extended survival. Therefore, it is important to test interventions to help these women control their symptoms and manage the uncertainty about recurrence, and improve their quality of life. There is some evidence that the impact of a breast cancer diagnosis is greater on African-American survivors and they experience more energy loss, sensory and sleep problems, pain and mental distress. African-American breast cancer survivors have rarely been included in intervention studies.

MUIC Intervention. MUIC has designed and tested a successful intervention (UMI) for older breast cancer survivors (mean 64 years of age) who were 5-9 years post treatment. The UMI consisted of audiotapes of cognitive coping skills to manage the triggers of intrusive thoughts about the uncertainty of recurrence, along with a manual containing strategies for managing long-term treatment side effects found among survivors. This is currently being distributed by the National Cancer Institute as a model intervention program.http://rtips.cancer.gov/rtips/rtips_details.do?programid=82&topicid=12&co=n&cg=
The link will go to “RTIPs Program Use Agreement” Please click accept button below to continue. Click on the “Product” image to download documents or to order a CD.

Given the prevalence of intrusive thoughts about recurrence with these women, we will place a greater focus on calming self-statements and cognitive restructuring to enhance the benefits of the intervention for this group. We will also include a new component on skills in communication with the health care provider. The cognitive behavioral strategies will again be primarily taught through a series of audiotapes that will be practiced by women on their own at home, and the revised manual will continue to be a self-help guide that women use on an as-needed basis.

Need: Chewing Gum for Study Subjects. The chewing gum is necessary for the cortisol collection part of the study. Cortisol in saliva is used as an indicator of stress levels. Chewing gum helps subjects produce saliva for the samples. Subjects are given one piece of gum for each saliva set required with two additional pieces for practice. Each subject sample requires 38 pieces of gum. MUIC needs to run 240 subjects, requiring about 9,120 pieces of gum. We are seeking a charitable gift from a donor to provide a tax-deductible contribution of $500 to enable the School of Nursing to purchase the gum for the study. MUIC is currently using Trident Original flavor. Any gum other than Trident Brand Original Flavor must be pre-approved by Brant Nix at the University of North Carolina at Chapel Hill School of Nursing Biobehavioral Laboratory to determine if additives or food coloring will affect the lab work.

Contact: Norma Hawthorne, Director of Advancement, UNC Chapel Hill School of Nursing, CB 7460Chapel Hill, NC 27599-7460. Norma_Hawthorne@unc.edu or call (919) 966-4619.

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