Student Essay: Caring for Children with Developmental Disabilities

I hope you’ll enjoy this essay written by a UNC Chapel Hill School of Nursing Pediatric Nurse Practitioner student about caring for children with developmental disabilities.

A journey into refocusing my nursing specialty

By Katie Shattuck

 “So, what do you want to be when you grow up?” We have all been asked this question at various points during our lifetime, in kindergarten during sharing time, in middle school writing class, and then again in high school as we prepare for our entrance into college. I always knew that I wanted to “help people.”  This idea transformed into a solid career path toward nursing after watching my sister go through nursing school and work as a registered nurse in a nursing home.

I applied to graduate school knowing that I wanted to earn my master’s degree in nursing to pursue a career as a Pediatric Nurse Practitioner. At the time, I would have laughed if you said to me that I would find an interest in children with developmental or behavioral disorders. In the fall of my second year in my master’s of nursing program, I was offered the opportunity to participate in NC Leadership Education in Neurodevelopmental Disabilities Fellowship (NC LEND), a yearlong fellowship sponsored by the Maternal and Child Health Branch of the United States Department of Health and Human Services. The purpose of  NC LEND  is to provide training about the complex issues surrounding children with developmental and behavioral disabilities. 

            I started the LEND fellowship unsure of not only what was expected of me but also how I could or would tailor this opportunity to fit in with the care that I was learning to provide as a Pediatric Nurse Practitioner. I had only a cursory knowledge of developmental and behavioral disorders and very limited experience with the community resources set up for these patients and their families. What I have learned over the past eight months has astounded me and made me realize how truly disadvantaged individuals with developmental and behavioral disorders are in terms of the quality of care that they receive.

            Anne (name has been changed) is a perfect example of how common fragmented and ineffective primary care is for individuals with developmental and behavioral disorders. Anne was ten years old with a diagnosis of severe autism spectrum disorder. Her parents came to the behavioral clinic in which I was participating with the hopes that a developmental behavioral specialist would be able to help them with the extreme tantrum behavior that Anne was exhibiting. They were also looking for ways to deal with her lack of self-toileting skills and her repetitive playing of specific clips of television shows.

Anne was also overweight, had a family history of cardiac disease, and during the visit with the behavioral specialist had symptoms of a cough and runny nose that had been going on for ten days. Her parents had not taken her to her primary care doctor for the cough because they assumed that the specialist could take care of anything that may be wrong with her medically. Unfortunately, the specialist addressed none of Anne’s medical concerns; these would have to be discussed with her primary care provider.

At this point during the exam I realized what is missing in our current system. On the one hand, we have great primary care providers who diagnose childhood illnesses. Top-notch primary care providers acknowledge when a child is overweight and start a discussion with the child and family about how to achieve a normal weight. Excellent primary care providers understand that children with chronic conditions like asthma need to have their seasonal allergies under control to help keep their asthma under better control.

On the other hand, we have specialists that know the ins and outs of developmental and behavioral disorders. These specialists have the education to feel comfortable prescribing psychostimulants, antipsychotics, and antidepressants to children when needed. Specialists know how to navigate the world of community resources that the layperson cannot navigate. What we have are two different sets of providers. While each of them performs a necessary function to treat this special population of children and adolescents with developmental or behavioral disorders, they are doing so separately.

In nursing school we spend a great deal of time talking about how we should treat the whole person – we call this holistic care. After eight months as a LEND fellow, I am dismayed to discover that it is a rare thing indeed to find someone who can or will provide both pieces of the puzzle for this population. Some of the barriers prohibiting primary care providers from adequately treating children with developmental or behavioral disorders include lack of insurance company reimbursements, time constraints in busy practices, and being uncomfortable with using screening tools to help diagnose children with developmental and behavioral disorders.

             In order to provide the quality, holistic care that we as nurses and advanced practice nurses have set as our standard, we need to make sure that we have the knowledge to treat these patients. We need to make sure that we willingly embark upon lifelong learning in the area of developmental and behavioral disorders to make sure that we are fighting against the norm of fragmented care in order to provide quality care to a most underserved population.

If you asked me today what I want to be when I grow up, I would still say that I want to “help people.” However, I would just be sure to state loud and clear that my goal is to “help provide cohesive, comprehensive care to children and adolescents with developmental and behavioral disorders.” I encourage you to do the same.

SON Alumna Nominated for Army Surgeon General

Maj. Gen. Patricia D. Horoho (BSN '82)

President Barack Obama has nominated Major General Patricia D. Horoho (BSN ’82) as the next Army Surgeon General. Maj. Gen.  Horoho is currently serving as the U.S. Army Deputy Surgeon General and 23rd Chief of the U.S. Army Nurse Corps. The nomination, which must be confirmed by the Senate, includes promotion to the rank of three-star general. Horoho would be the first woman to serve as Army Surgeon General.

Major General Horoho earned her BSN degree from the UNC Chapel Hill School of Nursing in 1982. She was honored  by Time Life Publications, the American Red Cross, and Nursing Spectrum for her care and action as a first responder when Flight 77 crashed into the Pentagon on Sept. 11, 2001.

Read more about the nomination in these stories:

Obama nominates E.E. Smith grad for Army surgeon general
Horoho nominated to be next surgeon general
Horoho Nominated as First RN to Serve as Army Surgeon 

Service Learning Trip to Honduras

UNC Chapel Hill School of Nursing students and faculty participated in a service learning trip to Honduras during  Spring Break. Before the trip the Association of Student Nurses helped collect vitamin and over the counter medications for the group to take with them.

Clinical Assistant Professor Jean Davison was the SON Course Coordinator and Team Leader for the multidisciplinary group, which included 20 students and nine volunteers who included two doctors, three nurse practitioners and two pharmacists. Nine of the students were from the School of Nursing.

View a slide show of pictures from their trip  here. Read the rest of this entry »

Cheryl B. Jones named Faculty of the Year by UNC Hospitals

Associate Professor Dr. Cheryl B. Jones

Associate Professor Dr. Cheryl B. Jones  has been chosen as Faculty of the Year by the UNC Hospitals  Nursing Division. She is the Research Consultant for UNC Hospitals, and one of her roles in this position is to foster research relationships between the School of Nursing and the Hospitals.

UNC Hospitals emphasizes nurses engaging in research to address critical problems in practice, and Dr. Jones is working with its nursing Research Council to develop a research agenda that guides its nursing research efforts. She also mentors teams at the Hospitals that have research ideas or are developing ideas into research proposals.

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7th Annual Aging Exchange

The Annual Aging Exchange is an event dedicated to recognizing and promoting research in the field of aging at UNC-Chapel Hill. It will be held at the Friday Center in Chapel Hill on Thursday, April 7th from 3:00 p.m.-6:00 p.m. It is open to the public and free parking is available.

The UNC Institute on Aging, in collaboration with its co-sponsors, will host this event.

The program will feature:
*A guest lecture by Dr. Margaret Moss, Yale University School of Nursing
*Poster presentations by UNC-Chapel Hill graduate students and faculty
*Presentation of the Gordon H. DeFriese Career Development in Aging Research Awards
*A reception with light hors d’oeuvres
*An opportunity to network with colleagues, students, and other attendees with an interest in aging-related research

Find the complete schedule here and directions here.

This event is free and open to the public, but please RSVP by e-mailing or calling Diane Wurzinger: diane_wurzinger@unc.edu or call (919)843-2647.

Medical Spanish App Free Until April 7th

The Polyglot Med Spanish app can help bridge the communication gap between health care providers and Spanish-speaking patients. It offers immediate audio translation of over 3,000 common words, phrases and assessment questions from English to Spanish and from Spanish to English. From February 28th to April 7th the app will be available for FREE.

The original Polyglot: Multimedia Medical Spanish Translator was developed in 1999 by a Duke University medical student, BJ Lawson. Since 1999, the Duke AHEC Program has distributed CD-ROM versions of Polyglot to healthcare providers and health professions students across North Carolina with the support of the NC AHEC Program. One past user of Polyglot stated, “The program helped me tremendously in learning certain phrases.” Polyglot Med Spanish is available for use on the iPhone, iPod Touch, and the iPad.

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Nurse Practitioners are Trusted Healthcare Partners

 WASHINGTON, March 1, 2011 /PRNewswire-USNewswire/ — When you have your annual check-up with your healthcare practitioner, who do you typically see? If you’re seeing a nurse practitioner (NP)—advanced practice nurses —you can feel comfortable that they are providing high-quality healthcare services, focusing on health promotion, disease prevention, health education and counseling. Nurse practitioners are known for helping patients make wise health and lifestyle choices.

While research(1) conducted by the American Academy of Nurse Practitioners (AANP) shows that 81 percent of Americans have had or know someone who has had a direct experience with a nurse practitioner, still many are not sure exactly what role this valuable healthcare practitioner plays in the healthcare paradigm. And as consumers are increasingly consulting with or being treated by a nurse practitioner, they may be curious about (or lack information on) what a nurse practitioner does generally, and what capabilities they have. In fact, 60 percent of U.S. adults admitted that they have no idea what a nurse practitioner’s capabilities are, or they could not articulate them. It may be time to brush up on that knowledge: who is the nurse practitioner?

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Watch the “I am a Carolina Nurse” Video

Share the link to the video with your friends: http://wp.me/pb6Ou-oS.

Being a “Carolina Nurse” has many dimensions.  This 7-minute video tells the story from the perspective of students, alumni, faculty, SON and hospital leaders who all experience the quality, energy and emotion of being connected to one of the leading Schools of Nursing in the United States.  Unrestricted private gifts made this video possible and we are grateful to our alumni and friends who provide on-going support to the School.  For giving opportunities, please contact Director of Advancement Norma_Hawthorne@unc.edu

National Nursing Leader to Present Research on Migrant Children

Mary Lou de Leon Siantz, PhD, RN, FAAN

Mary Lou de Leon Siantz, (PhD, RN, FAAN) the assistant dean of diversity and cultural affairs at the University of Pennsylvania School of Nursing, will present her research on immigrant and migrant children in “Children of the Road,” the 2011 UNC Chapel Hill School of Nursing Ethnic Minority Visiting Scholar Lecture. This free lecture is open to the public and will take place from 3:00-5:00 pm on February 21, 2011 at the School of Nursing.

de Leon Siantz was born in Los Angeles of Mexican immigrant parents. She has spent her career in community health nursing advancing immigrant mental health through research, education and national leadership. “One of the fastest growing populations in the United States is children of immigrants, yet very little is known about them,” she said. “So I studied the children and continue to do research and provide consultation in this area.”

For example, she is currently investigating how to reduce pregnancy and promote reproductive health among Latina girls in work supported by the Office of Minority Health, Department of Health and Human Service. “The risk for premature birth is greatly increased because of the teen’s developmental stage and lack of access to prenatal care in this group. Pregnancy is one of the top reasons that Latina girls drop out of school,” she said.

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SON Alumna Serves in Haiti

Tiffany Young, BSN ’99, has been in Haiti since June working as a Medical Program Coordinator for Samaritan’s Purse (photo and video courtesy of Samaritan’s Purse) . Health care teams in Haiti are now on the front lines of the cholera epidemic there. See Tiffany hard at work in the video below.

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