Faculty Profile: Deborah Mayer

Deborah Mayer is an associate professor at the School of Nursing and a member of the UNC Lineberger’s Cancer Prevention and Control program. Dr. Mayer’s research is on cancer survivorship. Read more about her in a faculty profile on page 4 of the UNC Lineberger Comprehensive Cancer Center’s Spring newsletter here.

Excerpt:
“I will do anything that’s involved with improving cancer care,” says Deborah Mayer, PhD, RN, AOCN, FAAN, associate professor of nursing and member of UNC Lineberger’s Cancer Prevention and Control program. Her work improves cancer care locally and nationally, and nursing was always her career choice. “I wanted to be a nurse since I was five years old,” she says. “I never wavered.”

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 Pediatric Clinical Students Featured

Clinical Assistant Professor Megan P. Williams was excited to see her pediatric clinical students pictured in an article from the N.C. Children’s Hospital. From left to right are Adria Gillespie,  Aaron Parsons, Victoria Neff & of course the star of the show Christian! Read the whole story here: http://www.ncchildrenshospital.org/calendarkids/christian.

Posted in Faculty, Nursing Education, Students. Tags: , N.C. Children’s Hospital. Leave a Comment »

Grant Supports Study of Ethical Issues in Dialysis Facilities

Mi-Kyung Song, PhD, RN

Associate Professor has received a grant ($50K) from the  which is administered by The Greenwall Foundation. The grant will support Dr. Song’s research project that  examines management of ethical issues in free-standing dialysis facilities. This prestigious award recognizes the significance and potential impact of individual research projects and researchers in bioethics areas. In the 62 years of the Foundation’s history, only two nurse researchers have been awarded grants.

Beth Black Receives NIH Funding to Study End of Life Care

Beth Black, PhD, RN

Assistant Professor has received funding from the National Institute of Nursing Research at NIH for her grant entitled “End-of-Life Care After Severe Fetal Diagnosis.” The grant is for $407,000 over 2 years to study the implementation of a perinatal palliative care program at the UNC Center for Maternal and Infant Health, and responses to a life-threatening fetal diagnosis by women, their partners and health care providers. Dr. , Cary C. Boshamer Professor, is a co-investigator and is a research adviser to the study.  

 
“We need to learn how to support these families in the best way possible. The way to learn is to talk to them, to find out what they need, identify their grief trajectory, and find out how they do after the loss,” Dr. Black says. In the long term, Dr. Black wants her work to provide a good theoretical foundation for the development of interventions for these families. She also wants to align perinatal issues with the end of life care issues conceptually. “I’m really committed to the care of these families. I want to find out from them and from their providers how we can best care for them in this heartbreaking situation.”
 
Look for more on Dr. Black’s work in the next issue of .

Study examines NC cancer patient emergency department visits

 

Deborah Mayer, PhD, RN, AOCN, FAAN

When cancer patients experience medical problems, they may visit emergency departments, but how often and for what reasons, there is little data.

A first-ever study of emergency room use by oncology patients in North Carolina was published in the May 23, 2011 online issue of the Journal of Clinical Oncology. Authors hope the study can give them information so that they can target clinical problems to improve delivery of quality cancer care, thus avoiding emergency room visits.

Deborah Mayer, PhD, RN, AOCN, FAAN, associate professor of nursing in the UNC School of Nursing, study lead author, said, “While some cancer patients develop acute problems that do require a visit to the emergency department, some visits might be avoided with better symptom management.” Mayer is a member of UNC Lineberger Comprehensive Cancer Center.

Read the rest of this entry »

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 

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