Monthly Archives: October 2017

Culture, History, and Nursing Development

When assistant professor Dr. Sheri Tesseyman graduated from nursing school, she got her first job at a small hospital in Mount Pleasant, Utah. She recalls that it only had twenty beds, ten of which were used for storage. The X-ray technician was also the town’s police chief, and the difference between the main area and the emergency room was whether you came in the front or the back door.

“That was a great experience,” she says. “It was a good place to be right out of school—you had to use everything you ever learned.”

Tesseyman has come a long way from that small-town clinic to working at BYU. She brings with her a wealth of interdisciplinary experience that includes a master’s degree in anthropology and a PhD in history from the University of Manchester in England.

After graduating from high school, Tesseyman lived with her family in Brazil for one year before returning to the US to study nursing at the University of Utah. She also worked as a licensed practical nurse between classes.

She later earned her master’s degree in nursing from BYU in 1989, where she also met her husband. She seemed to be on a good path, but Tesseyman knew that she wanted to expand her nursing experience into other fields, particularly anthropology.

Tesseyman is no stranger to foreign cultures—she lived in Brazil, served a mission in southern Texas, and spent a year in Mexico while studying at BYU. Back in the States, she found herself even more immersed in the study of cultures.

“I got a position with Utah Rural Development Corporation working with migrant workers in the orchards here in Utah County, which was great,” she explains. Her experiences with migrant laborers in Utah and Salt Lake Counties pushed her even more in the direction of further study.

Finally, Tesseyman decided to go back to school to get a PhD in anthropology. She initially studied medical anthropology at the University of Utah, but following the death of the university’s specialist, she was awarded a master’s in anthropology.

“That’s been a great lens to see the world through,” Tesseyman says. “I would highly recommend that to anybody in any field. Study anthropology because it really gives you a great perspective on society and people and cultures.”

She then decided to switch to the University of Manchester in England to get a PhD in history, with an emphasis on 19th century nursing. Much of her research has revolved around the differences in the development of nursing practices in England and the United States. While it might seem unorthodox to bring anthropology and history into nursing, Tesseyman passionately believes that both bring additional insight into current nursing practices.

“Nursing is changing really fast right now, and it’s fascinating to see how various crossroads in the past have led to the way that we do things now,” she says. “I think it’s important to understand that to know where we’re going and what that means for health care, what it means for nursing as a discipline, and what it means for patients.”

Between studying and working, Tesseyman has always found time for family. She and her husband have three kids, and one of their favorite activities is traveling. Her husband is from England, and the family has always put a large emphasis on taking “holiday” to travel abroad. Sunday night board games are also a family favorite.

Before coming to BYU, Tesseyman taught at Westminster College for twelve years.

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Redefining Disability Awareness

According to the US Census Bureau, nearly 56.7 million people in the US struggle with some form of disability. That means that for every five people you meet on the street, at least one of them could be dealing with some unique physical, mental, or emotional challenge. But as a member of the College of Nursing media team has discovered, there’s more to that person than meets the eye.

Jonathan Schroeder is the newest member of the College of Nursing media team. He’s also part of a new social advocacy project working to change how people see and talk about disabilities.

“Sometimes, no matter how hard we try not to, we see people with disabilities differently,” Schroeder says. “When we think of Joe, the first thing we think of isn’t a brilliant student with a sense of humor; we think of the guy in a wheel chair. We don’t remember Suzy as a stunning artist; the first thing we think of is the girl who suffers from serious anxiety or depression. We forget that these people are so much more than the challenges they face.”

Schroeder and three of his friends started More Than What I Have (More Than), a project that is working to change how society sees disabilities.

“The goal of More Than is to recognize people for who they really are; not just the disability or challenge they might have,” says Kimball Vaughn, one of the project leads.

More Than showcases individuals with a wide range of disabilities; from well-known disabilities like Muscular Dystrophy and Cerebral Palsy to more obscure ones like Crohn’s Disease or Raynaud’s Syndrome.

“Not all disabilities are visible,” project videographer Dan Hainesworth explains. “There are a lot of people who struggle with disabilities/conditions like anxiety or depression. We need to be just as aware of their needs as we would be with someone in a wheelchair.”

But rather than just highlight the disability itself, More Than is trying to emphasize all the amazing things that people with disabilities do.

“We’ve found a lot of really cool stories,” Schroeder shares. “For example, there’s a guy on the BYU Cheer Squad that has MS and a girl with severe depression who is an amazing make-up artist. We’re hoping that once we get enough stories out there, that people will start to see those who struggle with disabilities as more than just ‘a disabled person.’”

The group recently launched a #MoreThanWhatIHave challenge to help celebrate BYU’s Disability Awareness Week (October 23 – October 27). Participants are invited to create a simple 10-15 second video and post it on social media with the hashtag #MoreThanWhatIHave.

“The video challenge is a really easy way for anybody to show support for those with disabilities,” Vaughn explains. “All you need to do is pull out your cellphone and talk about a challenge you struggle with. It could be stress, stage fright, ADHD, sleeping troubles – whatever you feel like sharing. Then tell us how you define yourself. Share how you are ‘More Than What You Have.’”

“We’re really excited about this challenge,” Schroeder adds. “We hope that once people start to see themselves as “more than their challenges” that it’ll be easier to do the same for people with disabilities.”

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Health Tip 101: Make Time for Proper Hand-Washing

According to a Michigan State study, ninety-five percent of people don’t wash their hands properly after using the bathroom. But as startling as that statistic may sound, BYU College of Nursing professors aren’t phased by it.

“I believe it,” assistant teaching professor Karen Lundberg says, sharing her reaction to the study. “I think too many of us are complacent and don’t want to take the time to wash hands properly.” Lundberg teaches a Global Health class across rural Vietnam. She says that proper hand washing technique is one of the first things she teaches her young patients.

According to the Centers for Disease Control (CDC), proper hand-washing starts by getting your hands wet and applying soap to get a lather. The next step is to scrub your hands for at least 20 seconds, taking special care to lather the backs of the hands, between the fingers, and under fingernails.

“We teach children to sing the alphabet song while they wash their hands,” Lundberg suggests. “It’s something they can remember and helps them wash their hands thoroughly. It’s important that they take the time to expose germs to enough soap and water.” For those who don’t like to sing their ABCs, the CDC says that singing the “Happy Birthday” song two times from beginning to end is also a great way to measure proper hand lathering.

However, assistant teaching professor Daphne Thomas adds that just adding soap and water for 20 seconds isn’t enough to get your hands clean. You also need to get good friction between your hands.

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“Getting good friction during hand-washing is important because it gets the hands clean and helps get the germs off,” she says.

After 20 seconds of lathering and friction, the CDC recommends rinsing your hands with clean, running water, before drying them off using a clean towel or air dryer (for more, check out this handwashing demonstration video).

But if hand washing is such a simple task, why do so few of us take the time to do it right? Associate teaching professor Ron Ulberg shares his perspective from his time working on Intensive Care Units (ICU).

“We are constantly busy,” Ulberg explains. “Oftentimes we allow the busyness of what we’re doing to get in the way of the due diligence of hand-washing. As nurses, it’s important that we take the time to wash hands properly. We need to make sure we don’t bring in any germs when we work with the patient.” And as the weather gets colder and flu/cold season kicks into high gear, the presence of germs will only increase.

“Proper hand-washing is something that may seem really small and simple; it only takes a few extra seconds out of your day,” Lundberg says. “But in the long-run it’s so important to the health of our community.”

Will You Sing Me a Song?

As a part of the 50th anniversary of the BYU College of Nursing, a book was compiled called “The Healer’s Art: 50 stories for 50 years.” It has been 15 years since this book was first published and these stories were shared. We plan to regularly post selections from this book to help each of us remember and cherish the experiences of nursing and learning the Healer’s art. 

Will You Sing Me a Song?

Angela Williams

As a beginning nursing student with no previous medical background, I was determined to learn the ins and outs of every procedure and do an absolutely perfect job at clinical. My first and second days of clinical went all right and I gained a little more confidence. During the second week of clinical, I was determined to get some new nursing skills down and spent the day concentrating on the new world I was discovering at the hospital.

I was assigned to a basic Med-Surg floor and had one patient, an elderly gentleman, who was recovering from surgery. He was doing well and my duties were not that difficult, now that I look back, but it was a whole new world to me at the time. I was so nervous about doing something wrong that I focused more on what I had to do than on the patient himself. Each time I left the room, I would ask the patient if there was anything I could do for him. He smiled and answered, “Can you sing me a song?”

I took his request as a joke because who in the world would really want to hear me sing? Smiling back at him, I would respond, “Now, you really don’t want to make your ears sick too!”

He would smile at me and say nothing else as I went about my business. The next day the same gentleman was my patient. I went in and did my assessment as efficiently as possible, trying to concentrate on what I was supposed to be looking for and how exactly I would chart it. Again came the question, “Can you sing me a song?” and again the response, “You don’t really want to hear me sing.”

Later, while I was concentrating on making sure his medication dosages were right and that he swallowed all the pills, came the question, “How about a song?” with only a smile at my response. The day continued like this until lunchtime, when another nursing student came with me to deliver his lunch tray and to do the midday assessment. As I focused on finding his pedal pulses and deciding whether to grade them as a l+ or 2+ the same question came: “Do you have a song for me yet?”

But this time the response was different. As I was about to smile and laugh off his request, the other student nurse responded: “I think we can handle that. We’ll get some of the other students so you can have a real choir and we’ll sing you a song later this afternoon before we leave.”

His smile grew and I kept thinking, “Can we really sing him a song? That doesn’t seem very nurse-like.”

During post conference my friend recruited several students to join us in singing my patient a hymn. We picked the song “I Need Thee Every Hour” and, armed with a couple of hymnbooks, we stood at the end of his bed and sang him his song:

I need thee every hour, In joy or pain.

Come quickly and abide, Or life is vain.

I need thee, oh, I need thee;

Ev’ry hour I need thee!

Oh, bless me now, my Savior;

I come to thee!

(Church of Jesus Christ of Latter-day Saints, Hymn #98, 1985)

As the last note rang clear, we looked at each other and saw tears in everyone’s eyes. The patient took a deep breath and said, “That’s the best medicine I’ve gotten at this hospital yet.”

I left the hospital that day with one of the greatest lessons I’ve learned in nursing school, and to my surprise, found that it had nothing to do with assessments, procedures, or medications. It was that I, as a nurse, could take the time to participate in the healing of someone’s heart or soul. This is, unlike what I originally thought, part of the nurse’s domain. The trick, I discovered, is to really listen to my patients. They may not know what they need on the medical level, but they will convey what they need from you on the spiritual level. I am grateful that my friend knew that already and was willing to listen to my patient when I was too focused on my own learning to do what he really needed. Being a new nursing student, I found myself focused more on my learning rather than on truly caring for my patient. My friend took the time to listen and gave me a true example of The Healer’s Art.

Faculty Spotlight: Debra A. Mills

From the Fall 2017 magazine. See more at http://nursing.byu.edu/Content/development/fall2017-online.pdf

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Humbly Serving in the Background

There, in the background, a persistent woman keeps the college running. Associate teaching professor Debra Ann “Debbie” Mills (BS ’82, MS ’89), RN, MS, CNE, is the faculty member who helps make a nursing student’s life run smoothly. She organizes each semester’s class schedule, supervises the standardized testing, arranges a calendar for the ATI Nursing Education Program, and orders supplies. She trains faculty members to understand test results, works with the clinical agencies, and ensures that students pick up their books—all to help students fulfill their potential in learning the Healer’s art.

While on campus, Mills is the undergraduate program coordinator and a facilitator for her colleagues.

However, as soon as she leaves, she is an avid exerciser.

She regularly completes P90X, R.I.P.P.E.D., kickboxing, weightlifting, U-JAM Fitness, water aerobics, and TRX Endurance routines. She tries to be physically active for two hours a day and considers exercising her second job.

If you have met Mills, you will know she is a petite, gentle lady and does not seem to fit the mold of an aggressive gym rat. However, rumor has it that one day she got so caught up in her hard-hitting sets and reps that she broke the nose of her sparring partner.

Mills decided to become a nurse during her senior year of high school after having an opportunity to talk with a neighbor who served as a naval nurse.

After graduation she attended Ricks College to pursue a nursing degree. There she had the opportunity to learn in a classroom and a hospital. At that time there was no lab, so the nurses learned by watching filmstrips and practicing on each other.

The start to her nursing education had a few bumps. From not being able to find a pulse to being told to go home, Mills faced many discouraging challenges. However, she overcame them in a defining moment that concreted her desire to become a nurse.

The day after being told that she was not smart enough to be a nurse, Mills returned to the same hospital but under the direction of a different supervisor. This manager assigned her to care for a small senior woman who soiled herself daily. Mills’s first thought was, “You must be miserable—let me get you cleaned up.” So she did. She took care of this patient, cleaning her up and trying to make her as comfortable as possible.

However, giving such quality care made Mills late in giving some medication. She was certain the nurses would be upset. However, as she was leaving the floor that day, the unit manager stopped and said, “Thank you for taking care of one of God’s children.” At this point Mills knew she was going to be a nurse. It would be hard, but it would be worth it.

Mills worked in different places— Primary Children’s Hospital and Salt Lake Community College, to name a few—before finding a home at the Y in 1982. After receiving her bachelor’s and master’s degrees from the BYU College of Nursing, she accepted an offer to teach there and has been helping students and faculty ever since.

Mills’s list of accomplishments is extensive: a decade as baccalaureate studies coordinator, five years as a MORE evaluator to review evidenced-based nursing articles with a pediatric education focus, and 21 years as a college representative for the Primary Children’s Hospital Consortium.

She is a Utah State Board of Nursing committee member, was nominated for a 2005 Excellence in Pediatric Nursing Education Award from the Society of Pediatric Nurses, and was a 2002 recipient of the Excellence in Teaching Award from the Utah Nurses Association.

Mills is a great example of persistence, diligence, and hope.

Her experiences as a student help her to advise and encourage those students who are struggling as well as those who are exceeding expectations. From U-JAM to helping a student in a jam, Mills does it all so that people, including herself, find success

The Importance of Apologies

Marie Prothero received the college’s 2016 Alumni Achievement Award in recognition for her contribution to the nursing profession. This article contains excerpts from her BYU Homecoming address, delivered October 13, 2016.

“I believe that for us to move healthcare forward into achieving quality healthcare and outcomes, [we must] have transparency,” says Marie Mellor Prothero (MS ’96), MSN, RN, FACHE. A nurse administrator, Prothero is the executive director of quality for St. Mark’s Hospital in Salt Lake City. She oversees quality assurance for her organization that includes electronic reporting, patient concerns, and physician compliance. She also strives to improve process flow and safety efforts.

Prothero is currently working on a PhD in nursing from the University of Utah; her dissertation is focused on transparency in healthcare and the role of an apology following a medical error.

The attributes of an apology include expressing regret and sorrow, admitting fault with a statement that an error occurred, listening with dignity and respect, correcting the mistake and ensuring it will not happen again, and offering restitution to the victim.

Her studies highlight several antecedents, such as why we apologize and the corollaries of not apologizing when there is a medical mistake or accident.

“We must realize [that the] consequences of not apologizing affects our emotional, spiritual, and physical well-being,” says Prothero. “And if left unresolved, [mistakes] can create feelings of bitterness and even increase litigation and settlement costs.”

To give an effective apology, one must express regret and sorrow; you cannot fully apologize without remorse. “A conversation casually informing a patient of the error is inadequate,” says Prothero, “and so is a statement that seems forced and insults others’ intelligence.” Appropriately apologizing takes the right setting and practice.

Prothero’s research serves as a starting point for additional inquiry to explore the nature and types of apologies. It will help other nurse leaders identify what comes after the apology and if the patient-provider relationship can be repaired.

“There must be ongoing communication as additional details are learned—with the patient and family members, as well as with unit staff and hospital administrators,” she says. “Once we identify system changes, we need to involve others in the process to ensure needs are met and proper training occurs.”

Further, Prothero’s studies clarify the role of nursing in disclosure, apology, and the creation of a culture of safety in which everyone feels valued and able to speak up. “We must continue the important work of quality assurance, process improvement, and system improvement,” she says. “Never forget that every patient matters.”

She also emphasizes that nurses have the opportunity to be leaders with a broad impact in their organization.

“Leadership is interdisciplinary and [is] a team approach,” she says. “You must know your strengths and weaknesses and understand what you bring to the team. Then surround yourself with people who are different from you and learn from each other for success.”

Prothero has been a leader her whole career. Before St. Mark’s, she was the CEO of Utah Valley Specialty Hospital in Provo for seven years, a CEO of Ernest Health for four years, and an operations officer with Intermountain Healthcare for 22 years.

“Never stop learning and developing your nursing and leadership skills,” she concludes. “Success comes from ensuring the success of your peers. Take time to remove roadblocks, recognize achievement, and encourage others. By being a positive influence, you can see the best in your team.”

 

Alumni Perspectives

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From the Fall 2017 magazine. See more at http://nursing.byu.edu/Content/development/fall2017-online.pdf

 

My Career as an Adrenaline Junkie

I was a graduate in the fourth graduating class of our great college of nursing. I am an adrenaline junkie and had a fabulous 50-year career as a certified emergency nurse and mobile intensive care nurse. I had the pleasure of precepting many RNs and paramedics and saved many lives with the help of the Holy Ghost and the educational start at BYU.

Eleanore Hacking Scott (BS ’59)

Trinity Center, CA

 

A Lifesaving Education

As I was submitting the top three choices for my nursing capstone, I felt like I should put med/surg down as my first choice, even though I wasn’t particularly interested in that area. I was able to create a relationship with the med/surg director where I was placed and got hired there after graduation. The director was fantastic to work with, and after a few months of being there, I had my second baby. She let me come back to work PRN status and work just one shift per week, which was perfect for my family.

On Christmas Eve that year, my grandpa had a horrible, racking cough. He sounded just like the many pneumonia patients I had taken care of on the med/surg unit over the last year. He had been sick for a while but had refused to go to the doctor. Even that night as I talked to him, he wasn’t willing to seek medical help.

I talked to my mom and grandma and told them that I took care of lots of pneumonia patients in the hospital and that I thought they should take him in. They went to the ER, where the doctor diagnosed him with pneumonia and told them that they’d “gotten him there in time.” The doctor seemed to think that if they hadn’t brought him in that night, he would have died.

I’m so grateful for my nursing education and career that enabled me to save my grandpa’s life.

Julie Jacobs Taggart (BS ’07)

Orem, UT