Monthly Archives: October 2015

Last-Minute Halloween Ideas FOR SCRUBS

Halloween is in two days! Trick-or-treaters will be coming to your house dressed up as princesses, zombies, and sometimes even both! If you’ve been too busy to get a costume ready, look no further than this list for some last-minute costumes you can do with just a pair of scrubs and a couple accessories!

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Skeleton costume from Instructables

Skeleton: take a dark pair of scrubs and safety pin on white fabric cut out in the shape of bones. BONUS: turn your costume into a learning opportunity to teach anatomically correct names for various bones like the fingers *AHEM* phalanges. Find a great tutorial for fabric bones at Thrifty Fun or get extra fancy with this fabric paint tutorial from Instructables.

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Crayon costume from parents.com

Pink Panther: do you have a pair of pink scrubs sitting in the back of your closet? Add a tail and some ears and you’re ready for some Halloween sleuthing. Make a tail with just a feather boa, wire hanger, and some hot glue with this tutorial from Do It Yourself Divas. Use a headband and some felt to make some ears with this tutorial from Alpha Mom.

Crayon: wear your favorite pair of solid-colored scrubs with black adhesive felt letters and cuffs. Add a cone-shaped matching paper hat and you’re ready to add a splash of color to any Halloween gathering! Check out parents.com for an easy tutorial.

Zombie: have an old pair of scrubs? Rip them up and add some dirt and (fake) blood for good measure and you’ll look deathly good this Halloween. Go above and beyond with this amazing tutorial for makeup and special effects makeup from wikihow.

Nurse: go as a superhero in scrubs, saving lives one patient at a time!

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“Superhero in Scrubs” pin available from Quill

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Infection Prevention Week

Healthcare facilities are places of healing, where broken bodies can be mended.  Sometimes though, infection gets in the way of the healing process.Web Hand Sanitizer

The Association for Professionals in Infection Control and Epidemiology (APIC) reports that approximately 1 in 25 people in the U.S. get infections while in the hospital being treated for something else and 75,000 people in hospitals die each year with these same infections. Many could have been prevented with proper infection prevention practices.

This week is Infection Prevention Week and hand hygiene is one of the best things YOU can do to protect yourself and those around you from infection. Because of this, the College of Nursing will be giving out bottles of hand sanitizer, courtesy of the Henry Schein Company. Come to the Mary Jane Rawlinson Geertsen Nursing Learning Center (130 SWKT), Nursing Advisement Center (551 SWKT), or Dean’s Office (500 SWKT) to receive a complementary bottle.

Make sure to follow the College of Nursing on Twitter @BYU_Nursing and Instagram @byunursing for more infection prevention tips this week. For more information on Infection Prevention, see APIC’s Infection Prevention and You site.

Putting music on pause to be a nurse

Eight-year-old Elisabeth sat in the computer lab with the rest of her third grade class. Her eyes lit up as the computer screen showed the results of her career placement test: “I’m going to be a nurse!” She didn’t know she would have to give up three full-tuition scholarships in order to be one.

Boise native Elisabeth Harper has been developing a passion and talent for the oboe since the sixth grade. When Boise State and two colleges in Washington heard her play, they all offered her full-tuition scholarships. She had to make a decision between nursing and music.

“It was kind of a big choice to give up those scholarships but I knew that nursing is what I want to do for the rest of my life,” Harper says. “After I decided that I’ve been trying to keep up music as much I can. I don’t want to just let it go, it’s been such a big part of my life.”

The oboe is considered one of the hardest orchestral instruments to play, but Harper still managed to stay on top of both music and nursing through high school. She remembers how an important band class conflicted with a CNA class. She was worried that she was going to have to choose between them, but it worked out that she could take both. Decision time came when graduation rolled around.

“I really wanted to just do both for as long as I could,” Harper says. “I’m still trying to do the best I can at that.”

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Harper plays the oboe in concert. The oboe is notorious for its expensive reeds; each one can cost between $15-30. Photo credit: Jeanne Belfy

Harper’s friends and family were supportive in her decision, but they were also afraid she was letting something special go. “My oboe teacher back in Boise wanted me to study music so bad,” Harper says. “She tried to convince me every single lesson to study music instead of nursing. She was happy for me when I decided, but at the same time I think she kind of felt like I was stabbing her in the heart.”

Even though Harper was sure she wanted to be a nurse, there was no guarantee she would get into the BYU College of Nursing. “I was kind of nervous that I wouldn’t get into the program,” she says. “But I felt so strongly that this is what I was supposed to be doing so I wasn’t too worried. I knew that whatever happened would be okay, and I would end up a nurse somehow or other.” Even though she could have gone back and taken the scholarship offers, Harper felt once she made the decision to be a nurse there was no going back.

A desire to help people was one of the main driving forces behind her decision. “I feel like you can help people through music, but it’s not as direct as nursing; you don’t get to see the effects as easily,” she says. “That was something I was really excited about doing.”

Now in the third semester of the nursing program, Harper knows she’s already making a difference. “Something that I think is unique about the College of Nursing is that we are already doing it as we’re learning it,” she says. “We’re going into clinical settings and actually helping people. Even though we still have two years left of school we can make a difference now.”

The nursing program at BYU isn’t easy. On top of their rigorous course work, students have clinicals seven weeks out of the semester. During that time, they do a 12 hour shift at a hospital or medical facility once a week. Even though nursing means less sleep and more stress, Harper has stayed firm in her decision. “There’s no way I would go back and change my mind,” she says. “Even though it’s really hard, I still know nursing is what I want to do.”

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Harper poses with some of her classmates after participating in a blood pressure clinic. Photo credit: Elisabeth Harper

Harper wonders sometimes what might have happened if she had taken one of those scholarships, but moments with patients remind her why she chose nursing. She remembers her first day working at a long-term care facility when the CNA told her to put some TED hose on a patient. As hard as she tried to be gentle, the patient was hurting and kept asking her to stop. “It made my heart hurt,” she remembers. “I felt so bad.”

She ended up working with that patient her whole time there. On the last day of clinicals she put the TED hose on again like she had every week. This time the patient said, “You’re the best at that. You’re so gentle and you don’t make it hurt at all.” For Harper, getting to help someone hurt a little bit less made everything seem worth it.

Nursing will continue to be Harper’s main priority for the foreseeable future, but she still has dreams and goals for her oboe. “I would really love to play in a community orchestra wherever I end up,” she says. “I want to play in the orchestra at Temple Square as well. I think it’s something I could definitely do while still being a nurse as long as I keep it up.”

By Nate Brown—BYU College of Nursing public relations assistant

A Friend in Maternal Healthcare

This article by Rachel Peters was featured in the Fall 2014 edition of the college magazine.

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College of Nursing Assistant Teaching Professor Debra Edmunds

For Debra Edmunds (BS ’03), MSN, RN, CNE, the call to nursing is deeply personal.

“I would say a defining event was giving birth to a stillborn baby,” says Edmunds, an assistant teaching professor in the College of Nursing. During her stay at the hospital, she realized that no one knew quite what to do or say, and she was ultimately offered very little support to cope with her loss. This experience led her to realize, “I want to be a nurse that makes a difference.”

After her youngest child turned four, Edmunds began her university coursework for the first time. She received two associate’s degrees in nursing and health sciences from Salt Lake Community College, a bachelor’s in psychology from BYU in 2003, and a master’s in nursing education from the University of Utah in 2007.

As a nontraditional student and mother of five daughters and two living sons, Edmunds actively encourages women to pursue an education. “It’s never too late,” she says. “There’s still plenty of time to work, even if you don’t go to college until your 30s or 40s. I always offer support to women who are thinking of going back to school or changing careers.”

Beyond the realm of education, Edmunds uses healing as a way to empower and validate women.

“I spent many years working in a women’s health clinic,” says Edmunds. “Women’s health is more than providing encouragement and education; it is supporting and respecting each other’s choices and individual circumstances. There’s a season and an opportunity at different stages of life to contribute in different ways.”

One of her favorite quotes is from Oprah Winfrey: “God can dream a bigger dream for you than you could ever dream for yourself. Success comes when you surrender to that dream— and let it lead you to the next best place.” For Edmunds, nurturing women through maternity nursing roles brings happiness.

Because of her own experiences with labor and delivery, Edmunds knows firsthand what her patients are going through. “Bringing life experiences to the clinical setting allows me to share personal insights with others,” she says. “I’m able to provide bereavement support to help grieving moms realize and acknowledge that their sorrow is very real.”

She has written several unpublished poems that focus on the loss of a baby, some coauthored with her husband, Gary. The second stanza of her poem “Don’t Skip Past the Pain” reads:

There’s no easy shortcut to bypass the grief,

But your pathway will lead to a place of relief.

Embrace every moment both awesome and plain,

Make way for His peace—don’t skip past the pain.

In the College of Nursing, Edmunds codirects the refugee and immigrant section of the clinical practicum for Public and Global Health Nursing. During spring term, her students work with individuals who recently came to the United States. Some of these immigrants speak limited English, have few possessions, and need access to medical and dental care. Edmunds empowers her students to help these individuals improve themselves, and she works closely with caseworkers to find solutions when needed. (See a video featuring the refugee work of Edmunds and her students at nursing.byu.edu.) She also teaches Preview of Nursing as well as Nursing Care of Women and Newborns.

“My time at BYU has taught me that learning is spiritual and intellectual,” she says. “I am grateful to be able to assist those seeking maternal/newborn and women’s health nursing care.

Personalized Medicine: Risk Perceptions, Screening Behaviors, Communication in Breast Cancer

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In honor of Breast Cancer Awareness Month, we wanted to share with you some of the groundbreaking breast cancer research BYU College of Nursing Assistant Professor Deborah Himes is currently working on. This article can also be found in our Fall 2015 edition of “Learning the Healer’s Art.”

As we move into what has been termed the genomic era of medicine, primary care physicians must be prepared to care for the unique attributes of individual patients, right down to their DNA mutations. It is most effective to provide intensive screening and preventive care for those individuals with the most risk, a variable which is determined and influenced by a variety of factors including individual genetic makeup. This is a major component of personalized medicine.

Assistant Professor Deborah Himes (BS ’91) investigates how patients, family members and primary care providers (PCPs) communicate and utilize personalized risk information based on genetic predisposition to various cancers. Genetic predisposition occurs when a mutation of a germ cell, called a germline mutation, is passed down from parent to child. As cancer develops after an individual’s genes go through a series of mutations, individuals who inherit germline mutations require fewer mutations for cancer to develop because they start with genes that are already mutated. This increases their risk level and vulnerability to various cancers.

In addition to increasing the risk level of individuals, germline mutations pose a particular threat to families because multiple siblings can inherit the same mutation. Other factors, such as shared environments and similar lifestyles, also help to explain familial cancer clusters. Himes’s research focuses on women at risk for familial and hereditary breast cancer and (1) how they understand their risk (2) what they communicate about risk within their family and with their PCPs and (3) their screening practices and whether or not those practices are based on specific risk level guidelines.

To perform this study, Himes interviewed 85 women between the ages of 40 and 74 who each had a mother or sister who was diagnosed Capturewith breast cancer. In addition, each sister or mother had received genetic counseling and testing for hereditary breast cancer and an indeterminate negative test result, which means that while no genetic mutations were found, other mutations related to breast cancer that have not yet been discovered or that were not tested could still be present.

To see how women understand their risk level, Himes asked study participants to estimate their individual risk for breast cancer. These results were compared with risk levels calculated using the Gail, Claus, and BRCAPRO models. She found that most participants estimated their own risk to be much higher than what was calculated by the models. This is a concern because overestimation of risk can lead to increased anxiety and the possibility of over-screening. In contrast, accurate risk perception enables women to make informed choices about their healthcare and general well-being.

Himes also conducted a review of communication between family members in relation to genetic counseling and breast cancer. When a woman with breast cancer goes to a genetic counselor, she is told the results of her genetic test and what those results mean, which includes the implications for both herself and her family members. She is then encouraged to share this information with her family members. But Himes found that most family members felt that very little information was communicated with them by their sister or mother. In fact nearly 20 percent of study participants reported that no information was shared with them at all.  Additionally she found that participants who received more information from their sister or mother were twice as accurate in estimating their own risk level.

This study also investigated what information women communicate with their PCP. Because PCPs play an important role in assessing women’s risk for breast cancer and recommending screening tests, it is important that pertinent history information—such as a sister’s or mother’s breast cancer, genetic counseling, and genetic testing—be shared with them. In asking study participants what information they shared with their PCP in relation to breast cancer, Himes found that women are much more likely to share family cancer history than information about an individual family member’s genetic counseling and test results. This is an issue because lack of information has the potential to impair a PCP’s ability to interpret specific risk level and recommend screening tests.

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Finally, Himes looked at screening recommendations and practices and whether or not those recommendations are based on individualized risk levels. Understanding specific risk level is important because various organizations—such as the American Cancer Society (ACS), the National Comprehensive Cancer Network (NCCN), and the American Congress of Obstetricians and Gynecologists (ACOG)—publish recommendations for breast cancer screening based on risk level. For women with an elevated risk for breast cancer (lifetime risk greater than 20 percent), it is recommended they be offered annual screening breast MRIs in addition to mammography.

In her research Himes found that most participants received appropriate mammogram recommendations, whether they were at a high or average risk. However, of the 10 percent of participants who were determined to be high risk, none received or were even offered screening breast MRI; consequently, these women did not go through a more thorough and potentially lifesaving screening for breast cancer.

These findings indicate that there is an increased need for individualized breast-cancer risk assessment and risk-based screening recommendations in primary care.  Effective interventions are needed that will assist patients and PCPs in making informed decisions about screening and prevention measures related to breast cancer. The results of this study also indicate that there is an increased need for communications both within families and among professionals from a variety of disciplines. New interventions and policies may need to be implemented to fulfill this need.