Issue 11
Issue 11 November 2011
Sleep yourself
to Skinny
Working While
HIV Positive
Public Speaking
For The Nurse
Tax-Exempt Status
in American Hospitals
Nurses
Healing
With Art
Visit San Francisco’s
Golden Gate
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Fabulous Nurse Magazine
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Fabulous Nurse Magazine
Elsie Ekwa
Editor-in-Chief
riters W
The vision behind Fabulous Nurse Magazine, Ms. Ekwa saw the need for a lifestyle magazine that all at once serves as a celebration of nurses, a guide for better living, a resource for career development, and a guilt-free escape from the sometimes grueling shifts that nurses work. Ms. Ekwa’s distinguished career as a commercial model, college newspaper editor, and intensive care nurse informs and influences the creative and intellectual direction of Fabulous Nurse Magazine. This is evidenced by the magazine’s fresh approach to home life, dynamic content, inspiring stories about real nurses, and professionally relevant editorials. Ms. Ekwa is also the managing editor for the Pacific Writer’s Corner online magazine. She writes as Sonya Justice and speaks on health and wellness issues, the business of writing, and entrepreneurship.
Zee Nickerson Writer
Zee Nickerson has a B. S. in Psychology and has owned several successful Businesses. She is currently a writer, fashion consultant, and public speaker. Ms. Nickerson has taught English in Japan, Communist China and state side. As a thrifty world traveler, she can travel for as little as a $1.00 a mile. Along the way, she taught herself spoken and written French, German, and Japanese. She has traveled in all 49 states and would like to add Alaska to her collection. Her watercolor paintings are currently displayed at the Creator’s Gallery in Jacksonville, Oregon. Ms. Nickerson is pleased to announce she is just starting to twitter at HelloZee! A play on the French words for Let’s Go!
Olusegun Iselaiye Editor & Writer
Olusegun is seasoned freelance writer, researcher, and entrepreneur. He taught nursing students Human Anatomy in his home country of Nigeria before going into fulltime writing. Olusegun, whose mother happens to be a respiratory nurse, is also a huge fan of the nursing profession. His ambition is to offer a meaningful contribution to Africa and his home country. When some give his country a bad reputation, it is good to see that there are many who live by higher standards. It is thanks to Olusegun that Fabulous Nurse Magazine will be bringing you its rating system.
Margaret Smith Writer
Margaret Smith is a native Texan who loves God, family, country, and writing. She has a variety of interests, and has worked in diverse fields from retail to education. Although she is not a nurse, she has done volunteer work in hospitals, where she has always admired the dedication and skill of the nurses she has seen in action. She recently made the decision to become a full-time writer. Margaret enjoys the process of discovery and development in each new project. 6
Masthead/Contributor Publisher Sonya Publishing Corporation
Editorial Elsie Ekwa
Art & Graphic Design To submit artwork / ad creative Email: ads@fabulousnurse.com
Advertising & Marketing For advertising opportunities Email: ads@fabulousnurse.com Contact our Sales Director, Tel: (503) 877 – 3617
Writers To submit articles for publication Email: editor@fabulousnurse.com
Reach Us By Post Fabulous Nurse Magazine 29030 SW Town Center Loop E Ste. 202 Wilsonville, OR 97070-9490 info@fabulousnurse.com www.fabulousnurse.com
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Fabulous Nurse Magazine
Sara Caldwell Writer
Sara Caldwell is an award-winning writer and the author of three entertainment industry books published by Allworth Press. She has written projects for many healthcare organizations, including the American Hospital Association, the Joint Commission, and the American Optometric Association. Sara is a professor of Media Entertainment Arts at College of the Canyons in Santa Clarita, CA and a frequent workshop leader. She is represented by the ADA Management Group.
Mindy Carney Wirter
Mindy Carney has been a professional copywriter for over fifteen years, working primarily as a freelancer. While not a nurse, she grew up the daughter of a Radiologist and an RN. Mindy’s niece is an RN in a neurology ICU as she pursues her goal of becoming a nurse practitioner. Mindy is the single mom of two daughters, both adopted as infants in China. Mindy and her family have travelled back to China several times. Much of her writing has focused on adoption, parenting, and cultural balance. She holds both a B.A. and M.A. in Communication, having focused first on journalism and then on education. She believes in a lifelong journey of learning, and her favourite aspect of freelancing is delving into new topics and material.
Carol Sowell Writer
Carol Sowell has been a writer and editor for more than four decades. She has edited books for more than a dozen publishers on topics ranging from global economics to mystical sex. In addition, her articles have appeared in Today in PT, National Catholic Reporter, Modern Maturity, and other national publications. As national director of publications for the Muscular Dystrophy Association, she edited MDA’s prize-winning magazine, Quest, and wrote and edited educational materials about medical conditions, caregiving, health care services, and other aspects of living with a chronic disease. She lives in Tucson, Arizona.
Karen Kalis Writer
Karen Kalis has ten years of experience as a professional copywriter. She has worked in industries such as education, real estate, healthcare, technology, and with non-profit organizations. With an M.A. in Creative Writing, Karen’s clients include: Fabulous Nurse Magazine, RMS Technologies, Lincoln Electric, Multi-Care Management, and The EPIC Group. An entrepreneur at heart, Karen focuses on helping businesses communicate what they have to offer with precision.
Matthew Fowler Writer
Matthew Fowler, founder of A Sodality of Wordsmiths, is currently a professional writer for the US government, namely, the US Department of Labor, where he adjudicates claims and writes formal decisions regarding labor issues. He got his start in the career field of language arts as an active duty soldier, civil affairs division, writing press releases and the like. As an active duty soldier he traveled, literally, around the world in various capacities and including combat operations in Bosnia, the Philippines, and Afghanistan to deliver the Army story. His practical experience is bolstered by considerable education, a B.A in Communications and an M.P.A in Public Policy
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Fabulous Nurse Magazine
ditorial E
L
We are the privileged. We are nurses
etter to the editor:
I love nursing. My mom is a great nurse. All her friends are nurses and I grew up surrounded by nurses. My mom and her friends made it seem so easy. They worked in the same hospital. They joined the same associations. They attended the same conferences. When someone at work got pregnant, they joined the efforts to give them a baby shower. Just last year, a co-worker got sick and for weeks my mom talked about the efforts the hospital staff was making to help raise money for cancer treatments. Some people donated their sick time. They always made it seem so easy. Even their bad days were explained away as part of the deal. They stood up for one another and supported each other. As a little girl, I dreamed of someday becoming part of a group like my mom and her friends. It was like a sorority where you have to
pass the NCLEX to become a member. I worked very hard in nursing school to become just like my mom and her friends. But reality is a (bleep). It did not take me long to realize that what I saw as a wonderful friendship and a great support system works only for the members in it. There are clicks in the sorority group. And you are (bleep) out of luck if you are not considered a member of the click. I assumed nurses would embrace me and share the secrets of their knowledge. Some did but they are hard to find.
I have been told by my preceptor and manager that I am a good nurse. So it has nothing to do with my skill level. A co-worker jokingly said some nurses are threatened by other nurses who are younger and pretty. Can nurses really be this petty? Something has to change. Maybe there are nurses who care. I don’t want to change professions but this makes life very hard. What should I do? I know this is not the typical letter you receive. I hope you will publish my letter anyway. Rachel G. RN, Cardiovascular Intern. I made the editorial decision to publish Rachel’s letter because it highlights a latent problem in nursing. Some nurses really do eat their young. And by young I mean, youthful and/or new to the workplace. Reading this letter made me realize that yes, we nurses are indeed privileged. We have the opportunity to make a difference each and every day. What we do changes lives. It can be hard, yes; which is precisely why we need to support one another. Instead of being punitive, we need to encourage a culture of collaboration and professionalism. Find joy and happiness in the fact that you are doing something kind and noble. Not everyone can do what we do. We stand a world apart from other professions. Nurses belong to an exclusive club whose mission includes proudly dispensing good cheer and a healthy dose of TLC; one patient at a time. We are the privileged. We are nurses. So the next time you see one of us struggling like Rachel, reach out and lend a helping hand or a shoulder to cry on. Let it be your goal to help other nurses succeed as you have. We should strive to keep the good nurses. Only then can we grow and advance as a profession. We are nurses, after all. And, nurses do rock!
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Table of
Contents Issue 11
COVER ARTICLES
FEATURES
P.15
P.79
Anti-Aging Super Foods
P.55
Keep Government Out of the Bedroom
Tax-Exempt Status in American Hospitals
P.18
Public Speaking For The Nurse
P.22
Working While HIV Positive
P.64
Male Menopause
P.26
Nurses Healing With Art
P.28
Surviving an Estrogen Filled Workplace
P.68
Sleep yourself to Skinny
P.43
Foot Care Tips From Your Clogs
P.58
Visit San Francisco’s Golden Gate
P.74
Baby Monitor Gift Ideas
WORKING WHILE HIV+
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M
any nurses’ jobs include answering questions from people who have just learned they’re HIV positive. Nurses are well-trained to impart information about treatments, protection of loved ones, prognosis, etc., of the AIDS-related virus. But when it’s the nurse who has HIV, there’s a whole new set of questions about how the diagnosis might affect his or her work.
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Fabulous Nurse Magazine
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Find the location near you online at: AnytimeFitness.com
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Join today and receive: Complimentary Virtual Training Perfect for those who want to stay in-shape despite their long-shifts and odd-hours.
November 2011
Issue 11
Fabulous Foodie
P.81
Fabulous Recipes
P.83
3 Festive Thanksgiving Cocktails
P.85
Perricone Diet
Fabulous & Fit
EDITORIAL
P.88
Daily Mile Fitness Tracker
P.10
We are the privileged. We are nurses.
P.91
Pole Dancing Aerobics
Finance
THE NURSE’S STATION I Professional Development
P.94
Income Booster: Wedding Photographer
P.97
Dinning Out Frugally
P.32
The Fabulous Case Manager Nurse
FASHION WATCH
P.36
Accessorizing with Clogs
THE NURSE’S STATION II Facility Ratings
P.39
Scrubs Style: Then & Now
BEAUTY SECRETS
P.45
Rid Acne at Any Age
P.46
Nightshift Makeup. Perfected!
ATTITUDE RE-DEFINED
P.48
A Nurse’s Guide to Self Defense
WALK IN MY CLOGS
P.51
Leesa Domingo: Managing Care One Patient at a Time
TRAVEL
P.58
Visit San Francisco’s Golden Gate
BREAKROOM DISCUSSIONS Marriage & Dating
P.100 5 Star Hospital Rating: Mercy Hospital & Medical Center, Chicago Houston Medical Center, Georgia P.102
5 Star Staffing Agency Rating: Advance Nursing
P.105
5 Diamond Nursing School Rating: University of Alabama School of Nursing
P.109
Electronic Charts Rating EpicCare EMR
POETIC VOICE
P.110
The Nurse Educator’s Prayer
LAUGH OUT LOUD
P.112
Nursing Humor
P.112
General Humor
RESOURCES
P.70
Biggest Relationship Blunders
P.114
Book Review – Bedlam Among the Bedpan: Humor in Nursing
Home, Hobbies & Parenting
P.116
November Nursing Conferences
P.73
Know the Colors of Feng Shui
P.118
Job Opportunities – Perm & Travel
P.75
Fun Sticky Nature Collages
P.119
Nursing News – Press Releases 13
Fabulous Nurse Magazine
The
Nurse’s tation I S Professional
Development
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Issue 11
Evolution Of Tax Exempt Status In
By Olusegun Iselaiye
Historical View Historically, organizations operating fully based on one of the grounds stated under section 501(c) (3) of the Internal Revenue Code (IRC) got exempt from federal income taxes. In 1601, according to an article titled, “Hospitals Face Loss of Federal Tax-exempt Status” authored by R. Naubert and team and published in Healthcare Financial Management in September 1988, the English Parliament passed a law which exempted charitable establishments in charge of the sick from federal taxes. So, traditionally, America’s tax law is not different from this model.
American Hospitals
Current Trend Nowadays, demand for quality in America’s health care delivery, especially in terms of patient care and employee satisfaction, has occasioned hospitals’ repeated modification of their business models—to enable them stay in competition while meeting their customers’ needs by combining new and nontraditional services to remain in competition. Consequently, more questions as to why hospitals must be exempted from federal taxes are being asked by stakeholders. These questions are hinged on the fact that the broad justification for exempting organizations from federal taxes, which is premised upon serving public interest, is gradually bubbling out of America’s health care providers’ business contents.
Meaning of “Charitable” Since the concept of tax exempt in IRC Section 501(c) (3) originated from English common law of charitable trusts, it means there is a body of legal interpretation of the terms. Treasury Regulations’ definition of “Charitable” for instance comprises of the following: Relief of the poor and distressed or of the un-
derprivileged, advancement of religion, advancement of education or science, erection or maintenance of public buildings, monuments, or works, lessening of the burdens of Government, promotion of social welfare by organizations designed to accomplish any of the above purposes, or (i) to lessen neighborhood tensions; (ii) to eliminate prejudice and discrimination; (iii) to defend human and civil rights secured by law; or (iv) to combat community deterioration and juvenile delinquency. IRC Section 501 has 28 exempt categories, the most popular being Section 501(c) (3). An organization can only qualify under this section if its articles limit its activities to the tax-exempt purposes. These tax exempt purposes include charitable, educational, literary, religious, scientific, testing for public safety, to foster national or international amateur sports competition, promote the arts or for the prevention of cruelty to children
or animals.
Criticism of Hospitals Prioritizing Profit Over Care The concerns expressed over the relevance, rightness and even underlying principle for granting hospital tax-exempt have generated serious controversies among stakeholders. To avoid being one-sided on this issue, a quick analysis of the tax-exempt benefits to hospitals is worth considering. Tom Wang and Jacob Wambsganns 1996 Healthcare Financial Management article titled, “Is your organization’s tax-exempt status at risk? —tax management for healthcare organizations” states that “Government and private tax experts estimate that healthcare organizations save $15 billion a year in Federal, state, and local taxes because of their taxexempt status.” This, of course, is a benefit of tax-exempt. 15
Fabulous Nurse Magazine
Regardless of the merit and fiscal benefit of tax exempt, debate has continued and critics believe in the merits of stripping hospitals of their tax-exempt status. That is why they often refer to the 1990s when federal figures revealed a negative effect of tax exempt with regards to the nonprofit hospitals. Proponents of tax-exempt also mention Community Benefit—but the term “community benefit” in itself is legally unclear to most health care providers. Today, the community benefit concept—introduced by the IRS in 1969—is perceived by some experts as a fundamental error in polity, which needs a quick and permanent fix. They claim no universally adoptable definition for “community benefit,” and there is no best way to determine its usefulness or find its real impact on the populace. The Congressional Budget Office (CBO) expresses this more frankly by stating that “although non-profit hospitals must provide community benefits in order to receive tax exemptions, there is little consensus on what constitutes a community benefit or how to measure such benefits.” There are still other arguments that counter the idea of community benefit apart from those mentioned above. However, it is observed that federal courts seem favorably disposed to the idea of using community benefit as a standard even though their use of the standard is clearly not dependable. To put this in proper light, one landmark case easily comes to mind. In
St. David Health Care vs. United States, it was held by the Fifth Circuit that “the community benefit standard was the appropriate benchmark for analysis.” However, this does not explain the fact that the judgment seems skewed in another direction as the hospital was judged not to have met the guidelines stipulated in the (Section) 501 (c) (3). Today, different states have taken a more subtle and pragmatic approach to deal with the issue. In Utah for example, the ruling is that “nonprofit hospital is not a charitable entity for state property tax exemption.” On the other hand, Vermont is toeing the lines of the IRS by stating that in “extended tax-exempt status to non-profit hospitals because it saw the social value of care for the sick as being great enough to justify tax exemption.”
Government’s Review of Community Benefit Recent studies investigated community benefit coverage by other hospitals and nonprofit. These investigations include two studies by Government Accountability Office (GAO) in 2005 and 2008 and a study by the Congressional Budget Office in 2006. The studies generally show that community benefit reporting is not uniform among hospitals, and that community benefit expenditure and uncompensated care are concentrated in a relatively minuscule number of hospitals irrespective of their status—nonprofit, forprofit or government.
Recent Passage of the PPACA The recent enactment of the Patient Protection and Affordable Care Act (PPACA): section 9007 provides for the modification of federal income tax exemption for hospitals (non-profit based). In order not to run afoul of the law, the Act stipulates that the hospitals exempted from taxes have to embrace certain activities. Introduction of the PPACA became necessary because it is believed that hospitals cannot justify the benefits of taxexempt status if the level of healthcare delivery does not match what hospitals benefit. In view of this and the ambiguity of concepts like community benefit and charity care, the legislation is very important.
Challenges of Enforcing Compliance With New Requirements PPACA stipulates that all changes were effective starting from the tax year that followed March 23, 2010. The only exception was with the implementation of the community health needs assessment, which was shifted to the taxable year following two years after the initial implementation date (March 23, 2010). In spite of the concise changes that have been introduced, compliance has been a major concern. For hospitals that have been used to the status quo, crossing over to a new legislative regimen has been sluggish and far slower than envisioned.
Conclusion Over a period of decades, the American healthcare system has undergone quite a number of modifications, some of which were positive or for the worse. Irrespective of the nature of a policy, it always has its own controversial side. A classic example of this is the concept of tax exempt as introduced by the IRS in the late 1960s. To be fair, it has worked for the system but in the face of modern challenges, evolution must proceed. With the introduction of the PPACA, it is hoped that some of the grey areas in tax-exempt law as it concerns the health care industry would be resolved. As it is a pointer to a better future, some of the old challenges remain while we keep contending with new ones.
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&
Public Speaking Presentation Skills A Must For The Modern Nurse
Fabulous Nurse Magazine
Y
By Karen Kalis
ou’d think that public speaking wouldn’t be a job requirement for nurses, but that isn’t true.
With
more and more nurses involved in research, teaching, and leadership positions, having exemplary public speaking and presentation skills is a virtual must in the nursing field today.
Public Speaking Is Necessary For Nurses While most people don’t love public speaking, nurses who avoid it can slow down their career. According to Vicky, an RN and author of “Tips for Effective Public Speaking” AllNurses (July 4, 2009), “Public speaking is such a powerful form of communication that almost every profession requires it. The reluctance to get up in front of an audience can be a major impediment to career advancement.” Indeed, public speaking – whether to another group of nurses, a community group, physicians or business people – can open doors, as well as, provide new career opportunities for you. The good news is that despite the fact that many people cite public speaking as their number one fear, it is a skill that can be mastered, according to Gillianne Meek in her article “Enhancing Nurses’ Presentation Skills,” (June, 2005). “Nurses frequently have to give presentations, whether as part of a job interview, as feedback from a course or 18
conference or simply as part of a professional development program. It can be daunting. However, giving effective presentations is a skill everyone can learn.”
How To Prepare If you are asked to do a presentation, here are some key considerations to keep in mind when preparing. First, ask good questions
Issue 11
of the people that are asking you to speak.
hours, public speaking may require a change
is critical and will help you develop your
How long do they want you to speak? What
of dress. What you wear will change how
professional image and reputation. Beverly
topic would they like you to cover? Where
you feel, so choose carefully, always select-
Malone, Ph.D., R.N., F.A.A.N., the National
will you be speaking? Is it a formal speech
ing the most professional appearance.
League for Nursing Chief Executive Officer said, “It’s nice that you’re brilliant but, if you
or a casual Q & A format? Will anyone else be speaking? Who will you be addressing? Having all of this information provides you with critical information as you prepare. Secondly, Vicky suggests that you, “Know your subject material thoroughly, including
Finding Your Niche While you may not enjoy public speaking now, you may learn to enjoy it. Public speaking was a skill that Karon White-Gib-
can’t pass it on, it’s for naught.” (“Future Academic Nurse Leaders Hone Presentation Skills, April 23, 2009, Robert Wood Johnson Foundation Speech).
son, an RN and host of her own television
As a nurse, you may never have considered
show, “Outspoken with Karon,” developed
public speaking a professional requirement,
along the way. “I was terrified of public
but as more and more nurses work outside of
speaking. Never took it in high school. I
the medical community, complete research
was asked to go to colleges and universities
that needs to be presented, and become nurse
A good deal of practice is the key to becom-
when [my book was published]. The bigger
educators, those public speaking skills be-
ing at ease when doing public speaking. Try
the crowd, the better I liked it. I was asked
come critical. With a little practice, no mat-
to vary your pitch, remember to speak loudly
a lot of questions that weren’t in the book.
ter how daunting speaking in front of a group
and look at the people you are speaking to.
What I learned is that you have to say what
may seem, you can master it.
Maintaining eye contact keeps your audi-
you have to say no matter what they ask you.
ence paying attention to you. You may even
You have to get a message across,” she said.
the purpose of the presentation. Know it so well that you generate enthusiasm. Preparation is one of the most important factors for oral communication success.”
pick up subtle body language as you speak.
That is sage advice. As a nurse you know
Another area where nurses may need coach-
that no matter the interruption or distraction,
ing on public speaking is on what to wear.
you must stick to your job. Public speaking
While scrubs may be appropriate for on-duty
is no different. Completing your message
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Fabulous Nurse Magazine
UNIVERSITY OF CENTRAL FLORIDA UCF College of Nursing Offers Advanced Doctoral Degree Online ORLANDO, Aug. 29, 2011 -- A new doctoral degree
support the growth of practice-based doctoral degrees to
track at the University of Central Florida prepares nurses
address national concerns about quality of care and pa-
in a leadership role to succeed at the highest level of ad-
tient safety. UCF’s program will prepare nurses to use the
vanced practice by becoming “change leaders.”
latest technologies, trends and research to address chang-
The degree track, a post-master’s Executive Doctor of
ing regulations and anticipated nursing shortages over the
Nursing Practice (D.N.P.), is the most recent example of
next decade.
the College of Nursing’s efforts at creating cutting-edge
Designed for working professionals, the part-time, flex-
programs that give its graduates the ability to adapt and
ible degree consists of online courses and an intensive
lead during challenging times in healthcare. The track
three-day seminar at the start of each semester. The semi-
will prepare students to shape practice, and their proj-
nar brings together theory and practice to round out the
ects will make a difference in improving care for patients
comprehensive program.
where they work. “For busy nurse leaders, the program promotes out-of-
leadership and organizational analysis. In addition to
the-box thinking to shake up what they are already do-
opportunities for online collaboration with peers, the
ing, to support them in becoming change leaders,” said
seminar will allow students to meet their professors and
Associate Dean for Graduate Affairs and Professor Susan
develop deeper relationships with faculty members and
Chase. “They’re not just responding to new policies, but
their colleagues. Nationally recognized leaders in health-
informing the policy and putting into practice the evi-
care will share their best practices during the seminars
dence that is there.”
and in presentations open to interested nurses in the Or-
The federal Institute of Medicine and other groups are
lando area.
calling for more advanced educational programs as the
The first group of students, who will stay together for the
nation’s healthcare environment grows ever more com-
required nine semesters, starts coursework in January.
plex and demands of nurses a higher scientific knowledge and practice expertise. The American Association of Colleges of Nursing (AACN) and its member schools also
20
Curriculum focuses on areas such as decision making,
As nurse leaders and administrators plan for policy changes, the Executive D.N.P. will provide them with analytic
Issue 11
skills they can use to actively impact the environments in which
“We want them to think about the whole system of care, such as
they work, be it acute care, clinics, community health programs,
how to guarantee quality for outcomes, while letting people on
Magnet preparation, strategic planning or overall interdisciplin-
their teams be creative,” Associate Dean Chase said.
ary leadership. Through study and testing of evidence-based practice strategies, students will learn how to evaluate and apply existing research to improve practice innovations and outcomes. “It’s a new opportunity to prepare nurse executives from different backgrounds to change practice in ways which reflect their professional and personal interests,” said Diane Andrews, assistant professor and program coordinator. Led by UCF’s outstanding practicing faculty who have been on the front lines of change, students will put what they learn to work. The degree culminates with a project that is completed during residency, which allows nurse executives to examine how to improve patient care and safety.
Nurse executives who hold a M.S.N. in Nursing Leadership and Management are encouraged to apply. However, interested, registered nurse leaders with a non-nursing master’s degree also may apply. An online application with all supporting application materials is due Oct. 1. Eligibility will be considered with a portfolio review to determine course equivalency and verification of completed practice/laboratory hours. For candidates without a M.S.N., individual plans of study will be developed to include missing elements of the M.S.N. curriculum. Interested applicants may review additional program information and apply online at www.nursing.ucf.edu/academics/Executive_MSN-DNP.asp.
Contacts: Rebecca Basu, News & Information, 407-823-1637, rebecca.basu@ucf.edu Carolyn Petagno, College of Nursing, 407-823-1665, carolyn@ucf.edu UCF Stands For Opportunity: The University of Central Florida is a metropolitan research university that ranks as the 2nd largest in the nation with more than 56,000 students. UCF’s first classes were offered in 1968. The university offers impressive academic and research environments that power the region’s economic development. UCF’s culture of opportunity is driven by our diversity, Orlando environment, history of entrepreneurship and our youth, relevance and energy. For more information visit http://news.ucf.edu. 21
Fabulous Nurse Magazine
Working
While By Carol Sowell
Positive M
any nurses’ jobs include answering questions from people who have just learned they’re HIV positive. Nurses are well-trained to impart information about treatments, protection of loved ones, prognosis, etc., of the AIDS-related virus. But when it’s the nurse who has HIV, there’s a whole new set of questions about how the diagnosis might affect his or her work.
work often exposes them to bodily fluids, it might be wise to share the information with your supervisor. Be aware of discrimination against people living with HIV, even in a health care setting. A 2009 study of HIV-positive health care workers by the National AIDS Trust in Great
Can I still work as a nurse if I am HIV-positive?
nearly every other trade and profession.” Those who are taking HIV medications can
who disclosed their HIV status at work felt
There is no medical or legal reason why a
generally live and work for many years.
they were discriminated against as a result
nurse with HIV cannot continue to work.
With these drugs the viral load can be sup-
-- treated differently by supervisors, made
pressed to barely discernible levels, keeping
to feel isolated, and left out of social events.
On The Body, a website that calls itself “The Complete HIV/AIDS Resource,” David Wohl, associate professor of medicine at the
the immune system strong and significantly reducing the potential for transmission.
tors, pharmacists, GPs, and other healthcare workers, just as there are HIV-positive cleaners, teachers, bus drivers, police officers, and 22
NAT Assistant Director of Policy and Campaigns Eleanor Briggs said, “You might expect people in a healthcare setting to be the
University of North Carolina at Chapel Hill, says, “There are HIV-positive nurses, doc-
Britain showed that a fifth of respondents
Do I have to tell my supervisor that I’m HIV-positive? You are under no legal obligation to disclose your HIV status at work, but because nurses’
most informed. We found that wasn’t the case and people faced a range of negative responses.”
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Fabulous Nurse Magazine
If your diagnosis makes you fatigued or fre-
These policies should be designed only as
notified about the exposure; receive expert
quently ill, you may want to ask for some
precautions to protect patients. If you feel
counselling regarding the implications of
changes in your duties. You’re covered by
they’re limiting your professionalism or dis-
the event; be offered effective post-exposure
the Americans with Disabilities Act, but
criminating, consult with an ADA adviser.
prophylaxis; and receive appropriate long-
asking for ADA protection may require disclosure. Under the ADA, an employer or potential employer can’t ask about your health status but can ask if you’re able to perform a list of duties that are normally part of the job. The ADA only applies to workplaces with 15 or more employees.
Will I be putting patients at risk? Universal precautions designed to prevent transmission of blood-borne diseases work both ways. Gloves, gowns, masks, and protective eyewear will protect both patient and nurse from exposure to HIV through contact with blood. The chances of a nurse’s blood contacting patients’ open tissues are miniscule. But some facilities don’t allow HIV-positive nurses to participate in procedures that expose tissue such as handling acute trauma patients, inserting chest drains or making tissue repairs.
An article by Nursing Times (Nurses with HIV: Fear and Loathing on the Frontline, September 2, 2009) shares that HIV-infected nurses should have no problem with general procedures, intensive care, fitting IUDs, vaginal delivery or resuscitation performed wearing masks. It’s important for patients to know your clinic or hospital takes precautions seriously. Seeing nurses masked and gloved reassures them that the health care facility is committed to their safety and well-being.
Should patients be informed that I’m HIV-positive? The American Nurses Association is opposed to mandatory HIV testing and disclosure of status of patients, nurses, and nursing students. The ANA also opposes removing HIV-infected nurses from their care activi-
tion paper “The Patient’s Right to Know the HIV Status of the Health Care Provider” goes on to say, “The exposed patient need not be notified of the source provider’s name nor of the exact circumstances of the exposure.” Patients’ responses to an HIV-positive nurse will vary. A facility may choose to establish a policy of disclosure to protect itself from liability claims filed by a patient who believes he should have been informed.
Is it dangerous for me to continue working? It may be more dangerous for an HIV-positive nurse to continue treating patients than for the patient, simply by being in contact with patients who may have open wounds or other conditions favoring transmission.
ties based solely on the presence of HIV in-
Monitor your immune system status regular-
fection; the nursing work force in some areas
ly. If your system is weakened, you could be
of the world has been decimated because of
susceptible to patients’ infectious conditions
HIV infection.
such as pneumocystis pneumonia, tuberculo-
Similarly, the American College of Occupational and Environmental Medicine doesn’t support notification of patients of a health care worker’s HIV status unless an exposure has taken place. If a patient is exposed to the blood of an HIV-positive nurse, the Massachusetts Nursing Association advises that the patient and his or her physician “should be promptly
24
term medical follow-up.” The MNA’s posi-
sis, candidiasis, cytomegalovirus, and toxoplasmosis.
How do I deal with co-workers’ and patients’ misconceptions about HIV? Most staff members will be understanding about your HIV status and simply wish you the best. But sometimes even well-informed health care workers have some wrong ideas.
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