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There are 3.2 million registered nurses in the U.S., and that will not be nearly enough in coming years as the Affordable Care Act kicks in and baby boomers begin to need more care. According to the Bureau of Labor Statistics, the registered nursing workforce is expected to grow by 26 percent in the years ahead, with a full 1.2 million new nurses needed by 2020.
A new book called “The American Nurse” looks at the faces and stories behind those numbers, through portraits and essays of more than 75 men and women in several different caregiving capacities.
Photographer and filmmaker Carolyn Jones spent the last two years profiling changes in the health care system and the compassion of those on the front lines. She interviewed nurses who care for prisoners at Angola Prison in Louisiana to coal miners in Kentucky, wounded soldiers in California and hospice patients in Florida, among many others.
The diversity of the job surprised her. “I really thought a nurse was a nurse was a nurse. They take your blood pressure and your temperature,” she said. “I didn’t know there were so many different kinds of nurses and what all they do and how many different ways they touch our lives.”
In the interview above, Hari Sreenivasan sits down with Jones and Rhonda Collins — the registered nurse who created the project in her current role as vice president of health care company Fresenius Kabi USA — to discuss the role of nurses in American society and how the profession is evolving along with the rest of U.S. health care.
Below, “The American Nurse Project” team has assembled a list of eight nurses in the book with career paths that may surprise you.
If you’ve ever seen a roller derby it’s pretty obvious that those fierce warriors on wheels would need some medical attention from time to time. For the Windy City Rollers of Chicago that care comes from “Mama Doc,” aka Judy Ramsay, RN, PEDS-SPEC.
A quiet pediatric nurse by day, Mama Doc spends her evenings voluntarily treating the sprains, bumps and bruises that these fiery women receive both in and out of the rink. She consults them on their needs as athletes, but is also happy to discuss with them sensitive personal issues. Her own daughter is a competitor.
“I do get nervous watching [them] out there; my pulse starts racing. My daughter has broken her nose, her leg and her collarbone, but I don’t ever want to inhibit her from feeling that she could do everything she wants in her life.”
Ranking right up there with the MLB, NFL and NBA, NASCAR is currently one of the four most popular professional sports in America. But even sports fans need medical care, and the attendees of the Daytona 500 in Florida have someone looking out for them while they watch their favorite drivers compete.
Kathy Vance, RN, spends her time at the race doing an initial assessment of the racers and pit members after an accident, but more often than not, she’s helping to stabilize and treat injured or sick fans. She lovingly refers to some of her patients as Daytona’s “over-beveraged guests,” but she treats patients with more serious health issues, as well.
“One woman came in and she was actively having a myocardial infarction. I told her that she was having a heart attack and had to check into the hospital. She refused, saying, ‘I’m sorry. I’m not going to miss the 500 for this. I’ll go and see my doctor when we’re done.'”
Here’s a nursing career path for adrenaline junkies. Nurses at LifeNet in the Heartland out of Omaha, Neb., spend their days soaring over the plain states, rescuing patients from emergencies in remote places that are impossible to reach via ground transport.
Matt Tederman, BSN, CFRN, says, “Kids are always the toughest flights. A few years back, we had this kid who was on a snowmobile in a rural field. He didn’t see a barbed wire fence and ran right into it. He had a very severe laceration on his neck and was in pretty rough shape. We were able to secure his airway and the outcome was positive. It’s flights like that that make you feel you can provide a life-changing service for the patient and their family.”
The overwhelming majority of inmates at the maximum-security Louisiana State Penitentiary in Angola, La., are behind bars for life, which also means that’s where they will die. What’s unique about this place is that many of these prisoners will die in the company of compassionate hospice volunteers — inmates themselves — who are trained in hospice care by a corrections nurse.
Tonia Faust, CCNM, RN, is the hospice program coordinator there, and she and her inmate volunteers help to bring palliative care and emotional comfort to inmates in their last days of life.
“When I am working with a patient, my thoughts are in the present. I don’t look at their rap sheets, and I don’t know what the majority of my patients have done to be here. I don’t want to know. I know they’ve done something bad, but my job is to take care of a human being as if he were a family member. I don’t treat these patients any differently than I would a patient out on the street.”
Anyone acquainted with television shows like “Breaking Bad” or “The Wire” might feel they have a working knowledge of the culture behind drug production, distribution and abuse. But no one is more keenly aware of the harsh realities of that world than nurse Peggy Arvin, BSN, RN.
Working as a consultant with the state of Kentucky’s foster care system, Arvin has been on the forefront of helping identify the physical and psychological effects of drug abuse on the most unwitting victims of the trade: children. As meth production in Appalachia began to spike, there was a sudden influx of children coming into foster care with a whole litany of never-before-seen issues. Arvin took action: educating herself about the drug in order to create a protocol for EMS and child-welfare workers to use when they encountered children in a meth home.
“We have one child whose parents owed either meth or money to a relative who kidnapped the child and said, ‘Every day you don’t pay me, I am going to burn the child with a cigarette.’ The two year old was brought into foster care, and we found twenty-two burn marks on the child.” The hope is that with the right care, these neglected kids can be treated for their physical and emotional needs and placed in foster homes where they can have a chance at a new, more stable life.
Members of the LGBT community often face intimidating barriers when seeking adequate, compassionate health care. Health care professionals might not understand their specific needs or might be discriminatory against their lifestyle. Sometimes, in spite of their best intentions, something as simple as a question about gender can immediately alienate a patient.
That’s where Nathan Levitt, RN, MA, BSN, comes in. From his office at the Callen Lorde Community Health Center in New York, Levitt works double duty: he counsels and performs outreach to members of the local community, but he also functions as an educator to health care professionals, instructing them on how to provide LGBT patients with affirmative and sensitive health care.
“I did not know I wanted to be a nurse early on. I did a lot of LGBT-advocacy work and started working with doctors and nurses in San Francisco. That pushed me further to be a nurse because I wanted to help remove the barriers to care that I had faced myself. It’s best to ask, ‘How do you identify your sexual orientation?’ or ‘How do you identify your gender?’ or ‘What pronoun would you like me to use for you?’ What I love about nursing is developing trusting relationships with patients to help them feel more comfortable in an environment that may feel alienating and discriminatory. I just need more hours in the day and night to do the work I love.”
“My nickname here is ‘Pus Princess’. I don’t talk about my work at cocktail parties because people think a wound nurse deals in gunshot wounds. I say, ‘Not so much, more like chronic, non-healing things.’ That usually ends the small talk.”
Amanda Owen, BSN, RN, CWCN, is a wound specialist in the Johns Hopkins Hospital’s inpatient ward, treating people with problems the rest of us would probably rather not know about. “I tell people I went to school to become this glamorous looker of disgusting things,” Owens said. Some of her patients will never fully heal and must be continually managed, but some do have miraculous outcomes.
“I didn’t choose wound nursing; it chose me. I was a nurse on a medical nursing floor where I saw all kind of patients. My first successful wound patient was in the hospital for six months. I was able to try every wound product and technique on her to see what worked and what didn’t. Then we had another lady who had this horrible disease and who shouldn’t have healed, but she did because she had specialized care. At the time, the department did not have anyone who specialized in wound care, so that became my specialty.”
Some nurses aren’t only RNs, they’re also MDs and PhDs, as well, and their work can take place far outside of the realm of day-to-day patient care. Nurse Marilyn DeLuca, PhD, RN, MA, MPA works as both an educator and consultant on issues of public policy, both locally and globally.
Her career began on an ICU ward, but she soon felt she needed to have a better understanding of the policy issues driving health care reform on a larger scale, so she returned to school for a PhD in health policy.
“If we could start from scratch, we would build a very different health care system than the one we currently have. Many of our current problems — high costs and fragmented care — are the result of the unexpected consequences of policy decisions. In the coming years, nurses will likely play more dominant roles in health care delivery. They have the capacity and clinical skills to improve the continuity and quality of care. I would like to see a large-scale project to improve the continuity of care.”
All photos and footage courtesy of The American Nurse Project. Video edited by Justin Scuiletti.
Hari Sreenivasan joined the PBS NewsHour in 2009. He is the Anchor of PBS NewsHour Weekend and a Senior Correspondent for the nightly program.
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