A very significant factor impacting our health care system is the changing demographics of the United States. These changes are expressed in the changes in racial composition, age composition, and in socioeconomic status, just to name a few. One indisputable challenge in the provision of quality health care is how culturally competent will the health care provider be in caring for a population, community, or individual who does not look like her or him, and who may have very different values.
The impact of culturally competent health care has been evidenced via surveys of clients who have spoken of the importance of feeling personally valued and not “talked down to.” A leader in transcultural nursing care is Madeline Leininger. A model for the development of cultural competence is based on her work. The components of this model included cultural awareness, cultural knowledge, cultural skill, and cultural encounter.
In the Bradley University Department of Nursing, graduates possess the requisite knowledge and skills to provide competent care as evidenced by the pattern of success in passing licensing examinations. They also are challenged to cultivate a cultural competence that prepares them to provide nursing care to diverse communities, populations, and individuals. An initial awareness of the value of different cultures is present in the first nursing courses. Subsequent courses provide students with communication skills and cultural knowledge. The cultural encounter is blended throughout the clinical opportunities. Students care for clients of varying ages, varying stages in childbearing, from rural and urban settings, and from different racial backgrounds.
The Bradley nursing faculty is committed to preparing a graduate who is a critical thinker, who is capable of applying knowledge from the life and social sciences, and who blends these skills and capabilities in a manner that culturally values the individual. We prepare our graduates for professional settings that are both challenging and dynamic. The changing demographics of our nation are being implicitly and explicitly addressed.
Health and health care in the United States is in a state of crisis. Access to quality health care is a major indicator of a healthy community. The current nursing shortage has been reported to be affecting access to quality health care. Lack of nursing personnel in emergency departments causes overcrowding and long waits. Some hospitals have closed patient units and decreased available hospital beds due to a lack of nursing staff. High nurse-to-patient staffing ratios are related to medical errors and poor patient outcomes.
Changing demographics, job dissatisfaction, and nursing schools are partially responsible for the nursing shortage. As baby boomers age, the need for health care is increasing, and many more registered nurses will retire. The average age of a registered nurse today is 44 years old. Nurses are also expressing job dissatisfaction and burnout. Many have left the profession. One study reported one in three nurses under the age of 30 plans to leave his or her job. In addition, a decrease in the number of nursing graduates has occurred in the past decade. Although efforts have been made to increase student enrollment, some programs have turned away students due to a lack of qualified nursing faculty. The average age of a doctorally prepared faculty member is 51 years old. The shortage of nursing faculty complicates the plan for solving the nursing shortage.
Currently many strategies are being implemented to address the nursing shortage. Nurse leaders are working with legislators and hospital administrators to assure safe nurse-to-patient staffing ratios. Congress passed the Nurse Reinvestment Act to provide nursing scholarships and programs to inform young people about careers in nursing. Johnson and Johnson launched a Campaign for Nursing’s Future that has promoted nursing careers on TV commercials, the Internet, and recruitment brochures.
Bradley University is committed to quality baccalaureate and graduate nursing education. Graduates of the Bradley nursing program are experiencing high rates of success on the NCLEX-RN licensing exam and 100% job placement. Over the past few years, enrollment in the undergraduate and graduate nursing programs has steadily increased. The number of students currently in nursing classes rivals those of Bradley classes in the late 1970s. Both faculty and staff are cultivating an environment of excellence. The students are responding. With our focus on quality nursing care, we hope to impact the nursing shortage one Bradley grad at a time.
Several teenagers from Germany visited my daughter’s German class this fall. When asked about their first impression of Americans, one of the first responses was their surprise at how much “bigger” Americans are compared to Germans.
Approximately 60 million adults (or one third of the U. S. population) are obese while another 67 million adults are overweight. Obese individuals are at increased risk for developing major medical conditions such as Type 2 diabetes, coronary heart disease, hypertension, and osteoarthritis. Obesity also affects children, where it is estimated that 15% of American children between the ages of 6 to 19 years are obese. Childhood obesity puts children at risk for developing asthma, Type 2 diabetes, orthopedic complications, hypertension, and psychosocial effects and stigma.
The nursing curriculum at Bradley offers numerous opportunities for students to learn about healthy behaviors to prevent obesity. When appropriate, nursing students teach patients in the hospital and community settings how exercise and balanced nutrition impact their overall health and wellness. Nursing students participate in teaching projects related to the importance of exercise and nutrition in area schools. Several nursing courses (Men’s Health Issues, Women and Health, and Care of the School Age Child) are offered to non-nursing majors, where content pertaining to prevention of obesity and effects of obesity are addressed.
Leaders from both the public and private sectors have put a great deal of time and energy into making health care more affordable in this country, yet skyrocketing costs continue for both health care coverage and services.
Unfortunately, the majority of these costs goes towards the diagnosis and treatment of chronic illnesses such as diabetes, obesity, and cardiovascular disease. A much smaller amount goes towards prevention, yet evidence suggests that many of these conditions are indeed preventable. The large discrepancy is an obvious problem and will not change until society places a stronger emphasis on preventive care.
In Peoria, Premier Healthcare’s owners and physical therapists JD Nimrick ‘95, Tony Rapplean ‘98, and Jeff Varney focus on preventive and rehabilitative health services. Many people prefer taking a conservative approach to their medical care for a variety of reasons, including cost savings and a faster recovery time. While physical therapists acknowledge the importance of diagnostic tests, surgery, and medications for treating diseases, they also believe that they can do a great deal to prevent disease or at least delay the onset of disease through programs that focus on prevention and rehabilitation.
by Allison McDonald Vershaw ‘98,
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