N
r e t t e l s w e The Glen Taylor Nursing Institute
for Family and Society at Minnesota State
University, Mankato is dedicated to providing leadership
and expertise in family and societal health at local, state,
national and international levels. The Institute, Taylor Visiting Scholars and Becky Taylor Doctoral Fellowships are made possible by a
$7 million endowment established by Glen and Becky Taylor.
Webinar for IFNA
Fall 2016 • Issue 7
From the Director Greetings from the Taylor Institute! This newsletter introduces you to students, faculty, and nurses from both the University setting and health care systems who are focused on health of families and society. Students share their experiences of being able to care for families during times of stress and illness. Faculty teams highlight their research related to nurse-family conversations Dr. Sandra Eggenberger
with caregivers coping with a chronic illness in the
family. Nurses who care for hospitalized clients express their commitment to developing a nursing practice focused on family. In the midst of the important research, education, and practice projects that are the foundation of the Glen Taylor Nursing Institute, we remember that people and our relationships with partners are the keys to our success. I hope you enjoy these stories about who we are and what we are doing.
The School of Nursing’s model for simulating family care was the topic of a recent webinar that was offered by the International Family Nursing Association. Dr. Colleen Royle, an assistant professor in Minnesota State Mankato’s School of Nursing, presented the webinar Dec. 1. She described approaches to simulation teaching that Minnesota State Mankato faculty developed to help faculty and students “think family” during simulation learning experiences. This is the second of a series offered by Royle, who serves on the IFNA education committee and is one of 20 educators to participate in the 2016 National League for Nursing Leadership Development Program for Simulation Educators.
"I am so thankful for everything that we learned."
A recent School of Nursing alumna sent this letter to faculty about her experiences since graduation: Dear Dr. Norma Krumwiede:
Megan Pflaum
Since graduating this past spring, I started working on a medical surgical unit. This past evening when I was working, I experienced my first patient’s death. It was unexpected, but given his history, it was likely that this could have happened to him. During the dying process, I froze a little and did what I could, but looking back and reflecting on what happened, there were still things that I would have done differently. My amazing coworkers were there to help. One thing that I would not change was how I helped his extremely large family. With many sons and daughters, there were lots of relatives at the hospital.
In nursing school I remember thinking to myself, all of this information seems like common sense and that I would rather be spending more time in a medsurg class rather than a family class, but I was wrong. The entire night I was thinking back to what we learned in your family classes and I am so thankful for everything that we learned. I was there with the family to answer questions, I was silent and listened, and I was also there to ‘be with’ the family members as they were grieving. I offered them blankets, coffee, juice, snacks (knowing many of them had just driven long distances in the middle of the night). Although nervous, I still felt like I had the necessary skills to help care for this family during this time. In the end, the family was very thankful of everything that I was able to do for them. I just wanted to share this experience with you and thank you for all of the information that I learned in your classes, even though I once thought that it was nonsense. Feel free to share this with your classes. Only six months out of nursing school, and I am already realizing the importance of the family-focused curriculum that Minnesota State University, Mankato offers in its nursing program. Thanks, Megan Pflaum ’16
Translating Nursing and Technology
A Perfect Partnership
For the past two years, Bureau 507 has been working with clients inside and outside of Minnesota State Mankato. B507, as it’s called, employs more than a dozen students from a variety of disciplines, all toward providing “creative solutions to business needs.” Those are the words of project manager Mark Blashack, who lately finds himself acting as something of a translator between the not-so-similar lexicons of the School of Nursing and Information Technology. Blashack, a Nicollet, Minn., native who is pursuing his MBA at Minnesota State Mankato, has been managing a new recordkeeping system requested by the Glen Taylor Nursing Institute for Family and Society. The project is an electronic health record system that emphasizes family nursing. In other words, an easily accessible record of the big picture surrounding a patient’s health—a picture that includes family experiences, dynamics, and history. “They wanted to create an electronic health record that fits the need to have that family focus,” Blashack says.
Nursing students and faculty at Minnesota State Mankato and Winona State University are taking part in a collaborative approach to refine and implement a project called the Family Caring Conversation Protocol (FCCP). FCCP is ultimately designed to address and improve the health of family caregivers. The project grew from the premise that in chronic health situations, family caregivers frequently develop health concerns that exceed the patient’s. It is the latest endeavor by a group of nursing researchers who, since their collaborations began more than 20 years ago in Mankato, have expanded their turf to these two universities. In doing so, they are broadening the reach of family nursing education and practice throughout the state.
B507 has been working on creating a way to record additional aspects of a patient’s history, from heredity and mental health to ongoing emotional relationships and family support. Typically, patients supply this kind of information in several different ways, from conversations with providers to questions and answers on a clipboard or computer.
Professors Sonja Meiers, Sandra Eggenberger and Norma Krumwiede have been working together as part of the Family Nursing Research Team since 1995. Their work has been published in a variety of journals and books, their family nursing concepts have been integrated into graduate and undergraduate studies at Minnesota State Mankato, and they were honored to present their early work at the 2005 Douglas Moore Faculty Research Lecture.
“It gets filed or put in a box somewhere and they have to continually ask you time and time again to fill that information out for them,” Blashack says. “Putting family information in the electronic health record gives the nurses and doctors a platform to document it and then reference it after it’s been addressed.”
While Eggenberger and Krumwiede remain at Minnesota State Mankato, Meiers is the director of graduate nursing studies at Winona State University. Each of them continues to investigate family nursing and has fostered a unique collaboration between nursing faculty and students at Winona State and Minnesota State Mankato.
Just as this sort of record can call up a patient’s family history and social issues it can also be more complete. Using what’s called the eco-approach, Blashack says, “outlines the relationships they have: in-love, stressful, hostile… the nurse can get more of a grasp of their mental and emotional state, with the different entities in their life. It gives them a platform to map that out and to document it within the electronic health record as the patient and family manage the demands of an illness.”
These researchers and students from both universities have, since March, taken part in developing and refining the interviewing process that is a vital part of the FCCP.
Though he doesn’t have a health care background, (“I wish I did,” he laughs, “it would make a lot of things easier”) Blashack understands and admires the family nursing model fostered and implemented at Minnesota State Mankato. “To be honest, I’m kind of surprised that more institutions aren’t on board with this family-focused piece,” he says. “It seems to me that Minnesota State Mankato is kind of a leader in that industry, the front-runners, kind of blazing the trail for familyfocused health care.”
“When we first started doing our work in 1995, this evidence was not out there,” Meiers says. “It is now. It has now been quite well documented that, for instance, caregivers of persons with dementia really suffer significant depression. Cancer survivors’ family caregivers really do have some anxiety and depression.” The collaboration toward developing interviewing models and fine-tuning the protocol is exciting, Meiers says, in both the long and short-term effect on family nursing in the state. “The conversation is very rich around the table. They are constantly having new discoveries in their minds as to how this may be practiced,” she says. Students with family nursing training, she adds, “go away as different people, there’s no question. Between Mankato and Winona we are actually covering a fair amount of the state. … I feel like we’re having these little cells planted in a variety of settings. Not only in one hospital system, but broadly in the state. That’s important.”
Glen Taylor Nursing Institute for Family and Society
International Reputation
Training Nurses at HCMC
Dr. Marilyn Swan already knew Minnesota State Mankato’s nursing curriculum was ahead of the curve when it came to family nursing instruction. It was in Switzerland that she and a colleague discovered that many others around the world felt the same. In May, Drs. Swan and Kristen Abbott-Anderson—both assistant professors in Minnesota State Mankato’s nursing program—attended the three-day Externship in Advanced Family Nursing workshop in Winterthur, Switzerland. Nurse educators from five countries gathered to take in demonstrations on a variety of aspects on family nursing interviews, including the Illness Beliefs Model, which provides a framework to look at families in their environmental context. Swan and Abbott-Anderson were the only two attending from an American university—but it was clear that their university had a solid reputation for family nursing. “There was a recognition that Minnesota State Mankato had in fact incorporated family nursing into its curriculum, so I think we are seen as the leader internationally,” Swan said recently. Both professors were intrigued and impressed with the family interview demonstrations led by Drs. Lorraine Wright and Janice Bell. These family experts have served as Taylor Visiting Scholars and provided guidance on the Taylor Advisory Council. The Swiss organizer had found a family agreeable to being interviewed, and the result was enlightening and applicable to the Mankato curriculum. “To see Dr. Wright actually conduct that interview with a class watching was very beneficial,” Swan says. “When you’re in the room and somebody is sharing how they’re suffering in a situation. It’s really just beneficial to see an expert walk through and apply what we’ve been talking about in class.” Neither professor had to wait until returning to Mankato to put their observations to use. Making good on a longstanding invitation for Minnesota State Mankato nursing faculty to visit the IMC University of Applied Science in Krems, Austria, the two found themselves not only traveling to and observing hospitals, but lecturing undergraduates at the University on some of the basics of the Illness Beliefs Model. “They probably wouldn’t want a full theoretical overview,” Swan says. “We tried to give them some real nuggets they could take forward and apply as they go out and work in the practice. That was the focus of our talk, to give them pieces that were very usable.” One strong take-away for Swan was an appreciation of the resources available to nursing students in Mankato, and a renewed sense of Mankato’s reputation in the field of family nursing. “We are known for being innovators,” Swan says. “So when you sit there and you recognize that great tradition we have here at the School of Nursing for family nursing … that I’m a part of that and I have a responsibility to that as well. It really changes your perspective. “I really did gain valuable information and have a new appreciation for family nursing.”
When graduates of Minnesota State Mankato’s School of Nursing go to work at Hennepin County Medical Center, there’s a noticeable difference in their approach. “You always can tell the difference between the schools that come,” says Beth Heather, a nurse in the hospital’s surgical trauma intensive care unit. “You can see them thinking ahead already on things.” So it’s no wonder HCMC is working with faculty and students at the Glen Taylor Nursing Institute on an initiative to support communication between nurses and patients’ families. Over the past few months, Drs. Sara Ali, Patricia Beierwaltes and Sandra Eggenbeger have been documenting, through videotaped interviews, the challenges nurses have in communicating with and comforting families. Partnering with David Clisbee, an instructor in Information Technology at Minnesota State Mankato, these researchers are using storytelling interview methods to guide and coach nurses. “Family communication is very hard in the intensive care units,” Heather says. “They’re coming in crisis mode, the worst has happened to a loved one. These nurses have to figure out how to make a connection with them, and how to make them feel welcome and cared for. Oftentimes they’re caring for the family just as much as they care for the patient.” “Traditional nursing education doesn’t spend much time on the topic of family communication,” Heather adds. Nurses often discover that the hard way in a hospital environment that is heavy with emotion and panic and uncertainty. To address this, the hospital is pairing with nursing faculty from Minnesota State Mankato to create–through the interviews and other work–an education plan that will better prepare the nurses. Heather says that by March 2017, the work now under development will likely make its way into new orientation for HCMC nurses. “It’s going to be mandatory education for the whole unit,” she says. "By far," Heather adds, "Minnesota State Mankato takes the lead in training nursing students in the area of family communication and care. Mainstream nursing may be slow to catch up, but the loosening of family visiting hours at an ICU–once strictly limited to narrow windows of visiting hours–indicates an acknowledgement of the family’s significance in hospital health care." Lynn Kuechle, a project coordinator at the Glen Taylor Nursing Institute, said communication with families often remains a low priority in traditional nursing education, yet it can make a distinct difference in the quality of care as well as the comfort of the caregiver. “It's shocking how frightening it can be for nurses to care for families and it can be really overwhelming if they don't have all the skills in doing it.” Kuechle says. “It’s people like Beth who are trying to help them work through and get them comfortable and see the value in committing themselves to a family.”
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A member of the Minnesota State system and an Affirmative Action/Equal Opportunity University. This document is available in alternative format to individuals with disabilities by calling 507-389-1165, or 800-627-3529 or 711 (MRS/TTY). NURS108NE 12-16
Upcoming Conferences Several Minnesota State Mankato School of Nursing faculty are involved in upcoming conferences. These conferences include:
Midwest Nursing Research Society MNRS 41st Annual Research Conference Theme: Harnessing Big Data and Nursing Science to Improve Health April 6 - 9, 2017 Hyatt Regency Minneapolis For more information visit: www.mnrs.org/annual-conference/general-information Note: An abstract, “Digital Storytelling: A Translation Strategy Guides Education in the Adult Hospital Setting” has been accepted for paper presentation at the Guaranteed Family Health Symposium: Improving Family Health across the Lifespan: Clinical Translation and Family Science.
13th International Family Nursing Conference (IFNC) June 14 – 17, 2017 (Pre-conference Workshops June 14) University of Navarra, Pamplona, Spain For more information visit: http://internationalfamilynursing.org/2016/04/01/2017-conference/ Note: Several School of Nursing faculty are planning to share posters/papers, and several have submitted IFNC applications. A preconference session: “Applying IFNA Competencies through Nursing Education and Practice” is being offered by a School of Nursing team of faculty.
Glen Taylor Nursing Institute for Family and Society • Minnesota State University, Mankato