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Position Statement on Substance Use Disorder: Great Step Forward! July 8, 2017

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Impaired Nurses Benefit from Alternative-to-Discipline Approach

Jennifer Thew, RN, June 14, 2017

Nursing organizations advocate for rehabilitating rather than punishing nurses experiencing substance use disorder.

The American Association of Nurse Anesthetists is endorsing a new position statement that advocates for an alternative-to-discipline approach for nurses and nursing students with substance use disorder.

The position statement Substance Use Among Nurses and Nursing Students, co-authored by the International Nurses Society of Addictions and the Emergency Nurses Association calls for an alternative-to-discipline approach with the stated goals of:

  • Retention
  • Rehabilitation
  • Re-entry into safe, professional practice

The position statement also says drug diversion for personal use should be considered a symptom of a serious but treatable disorder rather than strictly as a crime.

“It’s about education for prevention and fair handling when it happens,” says Lynn Reede, DNP, MBA, CRNA, FNAP, AANA senior director of professional practice. “Education raises awareness and understanding, and at the same time decreases the stigma related to the disease. Treatment of substance use disorder helps keep patients and healthcare professionals safe.”

Recovery is the Goal

A disciplinary approach to impaired practice or drug diversion involves due process with a state board of nursing and suspension or revocation of a nurse’s professional license. There is no offer of a recovery program and the nurse may be terminated and legal charges can be filed.

Through an alternative-to-discipline program, a nurse does not practice for a specific time while undergoing treatment and establishing sobriety and recovery program. He or she may undergo psychiatric evaluations, specialized treatment like one-to-one therapy and support groups, and random drug screens.  A return-to-work agreement is created and often involves a reduction in hours, limited shifts, and restrictions in assignments with continued treatment and monitoring for periods of up to three to five years. Restrictions are lifted as the nurse demonstrates he or she is making progress.

Alternative-to-discipline programs make it easier for impaired nurses, including nurse anesthetists, to step away from work while they receive treatment, says the AANA in a news release.

“An ATD approach gives Certified Registered Nurse Anesthetists and student registered nurse anesthetists three opportunities: 1) To enter treatment to address their addiction, 2) To work toward lifelong sobriety, and 3) When possible, their eventual return to the workplace,” says Linda Stone, DNP, CRNA, chair of the AANA peer assistance advisors committee.


Response from Marie: This position statement is also included as a position statement of the American Nurses Association.

In our work creating and building the Nursing Peer Support Network (NPSN) in Minnesota, I believe the position taken here is vitally important.  Within the culture of nursing, there are negative attitudes toward addictions which act as a disincentive to get help when the person with the addiction is a nurse.    One large piece of the problem is the lack of education for student nurses to understand the heightened risks and extreme consequences experienced when a nurse becomes an addict.   The incidence with nursing is now thought to be one in seven!!!   Fortunately, the U of M SON has developed a curriculum module that DOES present important information about the RISKS AND CONSEQUENCES OF ADDICTION IN NURSING. See our earlier post here for more information about that exciting curriculum addition!

For more information on NPSN go to the website www. npsn.org/mn

It’s great to be part of this point in time, moving forward together on this important issue!

Learning Objectives for upcoming RBC Symposium! June 2, 2017

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Register Today for the International Relationship-Based Care Symposium, co-sponsored by the University of Minnesota School of Nursing!

From Silos to Synergy: Showcasing Fierce Commitment to Extraordinary Care

June 19-23, 2017

Join experts in compassionate care, leadership, and organized development at the 2017 International Relationship-Based Care Symposium. During this event, you will identify strategies that you and your team can use to improve interprofessional collaboration; and learn practical tools and actions to achieve committed partnerships, cross-departmental teamwork, and cultural transformation.


In support of improving patient care, this activity is planned and implemented by the University of Minnesota, Interprofessional Continuing Education and Creative Health Care Management. The University of Minnesota, Interprofessional Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Upon completion of this activity, learners should be able to:

  • Identify how health care systems investing in Relationship-Based Care are improving interprofessional collaboration and cross-departmental teamwork.
  • Articulate how a culture grounded in mutual respect, trust, commitment, and accountability promotes well-being of patients, families, colleagues, and self.
  • Describe how all members of the health care team can experience joy and meaning in their work through full engagement and shared purpose.
  • Discuss how to cultivate a health care culture that promotes synergy between health care disciplines to bring the organization’s vision and mission to life in daily practice.
  • Identify best practices in interprofessional partnership resulting in improved health care outcomes.
  • Define ways in which technology can be a powerful vehicle for strengthening partnerships between the health care team and the patients and families they serve.

Don’t miss this exciting opportunity, we are looking forward to seeing you there!

Memorial Day Remembrance: Nurses Serving! May 29, 2017

Posted by mariemanthey in Academia, History, Inspiration, Leadership, Professional Practice.
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Wartime nursing is unique, but also those periods in history tend to have an outsize effect on peacetime nursing as well. During World War II for example, huge changes took place. No one wants war, but we can honor those who served. I personally find this period fascinating, and with my work with the Heritage committee at the University of Minnesota School of Nursing’s Alumni Society, have been able to delve into it with great delight. Here are a few notes on some of what took place then, creating our present moment today.

As of 1943 the US Public Health Service had already funneled $ 5.7 m into nursing education, to stem the inevitable shortage of nurses, even as they knew that amount would be insufficient.

So Frances Payne Bolton, US Rep from Ohio, set in motion the Cadet Nurse Corps which was signed in to law that year. Under that program $150m was dispersed for scholarships and direct stipends – uniformly across the country, without regard for race and ethnicity, to all nursing schools.

Not only did this result in a massive surge of paramilitary recruits (targets were met every year), but nursing schools themselves radically transformed. The program was terminated in 1948, but by then 124,000 women had been enrolled, and nursing schools – especially those serving non-white populations – took huge steps forward in the condition of their facilities and equipment.

Here in Minnesota,  Katherine J. Densford, Director of Nursing at the U of Minnesota, was another leader active during that period, serving as president of the American Nurses Association among other positions.  She worked closely with Payne Bolton and Roosevelt to help supply nurses to the front lines – the University of Minnesota School of Nursing educated 10% of all US Cadet nurses educated during that period.

Densford also determined that the lag time between when nurses completed the recruitment application and when they were actually inducted actually took 6-8 months initially. She spear-headed efforts to reduce the bureaucratic tangle and as a result that lag time was reduced down to only 4-6 weeks!

A much needed -addition to the  Powell Hall nurses dormitory was built at the University of Minnesota with  Cadet Funds, and this is where I had my office while Primary Nursing was being created.

Another tidbit I wanted to share: May 1944, the national induction ceremony was held in DC, and it was for all nurses being inducted around the country, and so it was broadcast nationally on the radio.   KSTP carried in the Twin Cities. Thousands of nurses attended the induction  in Minnesota at the Northrop auditorium. The program included a song composed for the occasion, sung by Bing Crosby.

The ‘snappy’ nurse cadet uniform was actually created by Edith Heard – a famous Hollywood costume designer.  Wearing this uniform gave Cadet nurses the same ‘perks’ given to military men and women….like free admission to movies!

This bold initiative was a vital part of the war effort, serving both the military and civilian hospital needs.   This memorial day is a good time to remember the dedicated nurses who saved the lives of soldiers on the battle field.


Additional resources:

U of MN School of Nursing History

Leadership at the U of MN School of Nursing

Smithsonian website for the National Museum of American History, Kenneth E. Behring Center:

Symposium Update! May 15, 2017

Posted by mariemanthey in Academia, Creative Health Care Management, Inspiration, Leadership, Professional Practice.
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5 Reasons to Attend the 2017 International Relationship-Based Care Symposium – June 20-22 – Minneapolis, Minnesota

The 2017 International Relationship-Based Care Symposium is only five weeks away! It will be an event filled with inspiration, practical action, healing and hope for the future. Need more reasons to attend? Check out the brochure here, and book your flight!

  • Like-minded People with Shared Commitment:Surround yourself with an international community of health care leaders who are transforming the way health care is provided. You will leave inspired and have a renewed commitment to achieve excellence in health care.
  • Dynamic Speakers: David Cooperrider will engage you in the synergistic process of Appreciative Inquiry to boldly envision and commit to a collective future for health care. You will discover more about compassionate partnerships and the art and science of healing relationships with Robin Youngson. Maestro Roger Nierenberg will place you in the middle of a professional orchestra for a multi-sensory experience in organizational dynamics.
  • Celebrate Outstanding Work in the Field:Honor colleagues and learn from stories of extraordinary innovation with the healthcare teams who discovered them. At the Symposium Poster Extravaganza, health care leaders from all over the world will share innovative strategies designed and implemented at their organizations to advance Relationship Based Care and Cultures of Excellence.
  • Interprofessional Continuing Education: We’re proud to be partnering with the University of Minnesota Interprofessional Continuing Education to offer contact hours for this event. The symposium will highlight the critical role of interprofessional relationships in the domains of safety, quality, and experience of health care.
  • YOU WON’T HAVE ANOTHER CHANCE UNTIL 2021! The symposium is only offered every 4 years. Don’t miss this opportunity. Participants from 2013 said, “The most powerful conference I have ever attended!” and “I came here this week with hopes of finding a way to break the barriers between MDs and RNs, and I’ve taken away with me so much more. This has not only been a career changing milestone but a personal stepping stone that I will never forget!”

Read more about the Symposium and register today at chcm.com/symposium. See you in Minneapolis!

Symposium Update! Urgency Building for this Exciting Event! May 8, 2017

Posted by mariemanthey in Academia, Creative Health Care Management, Leadership, Professional Practice, Values.
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CHCM’s International Relationship-Based Care Symposium

From Silos to Synergy: Showcasing Fierce Commitment to Extraordinary Care

June 19 – June 23, 2017

Minneapolis, MN

While people will be attending this event from around the country and around the world – some of you will be able to attend any/all days without traveling at all. CHCM Symposiums are sited in vibrant health-care communities, in order for those particular communities to have the special privilege of attending events within the comforts of home.

This post is especially for those of you who have that privilege this year!

The Relationship-Based Care Symposium is a magnificent program and since you live here, the options for
attending provide a wide range of choices. You really don’t want to miss this opportunity.  This is the first time we are offering the symposium locally to the Twin Cities community.   You can opt to attend one of the three
days…all three….or the pre- or the post- conference, or all of them.

This is a great opportunity.  Look carefully at all the speakers and you will see why you don’t want to miss this event.

Some highlights are:

* DAVID COOPERRIDER, the developer and creative thought leader of Appreciative Inquiry, a strengths-based approach to organizational change based on the best in people and their organizations
* ROGER NIERENBERG, a maestro who, with the help of a professional orchestra, provides a multi-sensory immersion experience of organizational dynamics and teaming
* ROBIN AND MEREDITH YOUNGSON, co-founders of New Zealand-based Hearts in Healthcare, which focuses on organizational strategy and movement building that’s centered on making health care more
* THE DAISY FOUNDATION, enhancing patient care by celebrating compassionate and extraordinary nurses through meaningful recognition
* TEDDIE POTTER WILL FACILITATE A DIALOGUE with Robin Youngson and an interprofessional team of young clinicians on PARTNERING ACROSS GENERATIONS.

The journey forward of Primary Nursing, and it’s broader implementation as Relationship-Based Care, will be celebrated, cultivated and innovated further at this  once-in-a-lifetime event.

Symposium Registration Information

Please check out the Brochure and the website and your co-workers and professional community. To obtain the group rate please email:  rbcsymposium@metroconnections.com with the list of all attendees in your group and you will receive a registration code.

This activity is planned and implemented by the University of Minnesota, Interprofessional Continuing Education and Creative Health Care Management. In support of improving patient care, the University of Minnesota, Interprofessional Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Register for the RBC Symposium today!

Please let me know any questions you have about this exciting event. We look forward to seeing all of you there!

Richard Olding Beard: An Extraordinary Feminist. May 7, 2017

Posted by mariemanthey in Academia, History, Inspiration, Professional Practice.
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This note is about a work-in-progress, a scratch pad entry from the Desk of Marie Manthey.. it includes a resource list at the end and an invitation to comment and join in the process!

Nursing and the Women’s Movement have had an interesting, challenging and contradictory relationship since modern nursing was born around the 1870’s.

Never a feminist herself, Florence Nightingale created a profession for nurses – for women – where none had existed before. This profession is based on values that have been associated with women.

Fast forward 40 years to the life of Richard Olding Beard, a professor of physiology in the University of Minnesota Medical School. His strong vision of the contribution nursing could make to the benefit of society gave the school of nursing a trajectory that continues to compel the future.

He founded the School of Nursing at the University of Minnesota, which was the first nursing education program within an academic institution. He clearly supported higher education for women and recognized the foundation of science in nursing. He presciently imbued the School of Nursing with multiple societal values that continue to be expressed in the work of its graduates today. Richard Olding Beard saw Nursing’s potential capacity for increasing social justice in the world; for example because of how nursing values the act of caring for the sick – all of them – without regard for position, wealth or status.

There is much more to come, in the full article. To end this preview, here is one of my favorite quotes of his:

“The history of a university or school – and particularly of a professional school – may be guided or misguided by its governing body, may be inspired or uninspired by its faculty, but it is actually written in the work and in the play, in the life and character, in the future achievements and influence of its students.” R. O. Beard, Graduation of the School of Nursing, September 1923.

Beard’s writings (articles mainly) have been a treasure trove for me, and I encourage you to check them out. There is a collection of his writings at the Anderson Archives at the University of Minnesota Library.

Additional information: Honoring the Past, Creating the Future – School of Nursing Celebrates a Century of Leadership. Minnesota Nursing, Spring/Summer 2009. P 2-3.

Please comment below with any questions, thoughts, anecdotes etc..!

MN Daily: UMN SON Curriculum to include Substance-Use Disorder April 29, 2017

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The School of Nursing incorporated a specialized curriculum into its degree program last year to make students aware of addiction and to address stigma surrounding the problem.

Professor Christine Mueller started the curriculum with doctoral student Dina Stewart, who will become a psychiatric mental health nurse practitioner upon graduation.

Stewart said addiction and substance abuse among nurses wasn’t something previously covered in her coursework.

Mueller said substance abuse has always been taught in the nursing program but only how it pertained to patients.

The curriculum is an attempt to highlight substance abuse as an issue among nurses, Mueller said.

Even though the addiction rate among nurses is on par with the general population — around 10 percent — substance abuse is often more evident and problematic given that nurses have easy access to medication, Stewart said.

“Just having that access puts them at a higher risk for developing substance abuse or misuse,” she said.

Mueller said nurses also work in a high-stress environment, which can lead to alcohol or drug abuse to cope with the stress.

“We want nursing students to be aware that this disorder is a risk for nurses [and] that they themselves can be at risk,” Mueller said.

The curriculum will teach students to identify the signs and symptoms of substance abuse and how to recognize behaviors in themselves and their colleagues, said Carol Flaten, director of pre-licensure programs for the nursing school.

It will help them understand that the earlier they seek help, the better the outcome will be, Flaten said.

Nurses need to be in a good position to provide safe care for their patients as well, she said.

Stewart said the curriculum would also cover the stigma and attitudes surrounding addiction.

Nursing is considered one of the most trusted professions in the healthcare system, Stewart said, and there are high ethical standards for nurses.

Nurses who find themselves struggling with substance abuse might not seek help because of how they will be viewed, Stewart said.

“But the truth is being addicted is a disease and it’s something that has to be identified and treated as a disease … when we think of something as a disease, then the stigma is lessened,” Mueller said.

If addiction is understood as a disease, then it will help nurses understand how to seek help and move forward rather than have it concealed, Flaten said.

The curriculum is part of the nursing program’s senior course titled “Nurse in Transition to Practice” and is intended to help prepare to join the professional world.

Mueller said the nursing school hopes to package and send the curriculum module to other Minnesota nursing  schools.

Substance-Use Disorders in Nursing: U of MN curriculum incl Manthey’s story (video link) April 26, 2017

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School leads collaborative efforts to address substance use disorders in nurses
by: Brett Stursa

The numbers are well documented. About one in 10 people in the United States has a substance use disorder, which mirrors the number of nurses and other health professionals with the illness.

That means about 300,000 nurses nationwide are living with a substance use disorder, and in Minnesota that translates to about 12,700 nurses.

While the numbers are straight forward, the consequences of substance use disorders on lives are complicated and nuanced. Concerned about the scope of the problem and its impact on patients and nurses’ well-being, Dean Connie White Delaney, PhD, RN, FAAN, FACMI, sought to identify strategies to address the issue of substance use disorder in nurses.

“Nobody is untouched by addiction,” said Delaney. “Even though it brings to the surface many difficult issues, it is critical to the health of our patients and nurses that we talk openly and address it.”

In 2014, Delaney invited state leaders in licensing, education and recovery, as well as the school’s largest clinical partners University of Minnesota Health and Fairview Health Services, to develop a deeper understanding of the landscape in Minnesota and identify a blueprint for action. All who were invited were quick to accept the invitation. Shirley Brekken, MS, RN, FAAN, executive director of the Minnesota Board of Nursing, was eager to get to work. “I think that each of us was looking for something, for a way to protect the public, be supportive of recovery and make nurses aware of how easily addiction can occur,” said Brekken. “There was recognition that if we do it together we can have a far greater impact than if each of us is operating on our own.”

“Nobody is untouched by addiction. Even though it brings to the surface many difficult issues, it is critical to the health of our patients and nurses that we talk openly and address it.” – Dean Connie White Delaney

The group, called Prevention Awareness Addiction Recovery Reentry and Support, quickly determined that education and support were priorities. Since the first meeting in 2014, the School of Nursing developed and launched an integrated statewide approach encompassing education, prevention, recovery and support.

Educating students on the risks

A stressful job, stigma and shame about substance abuse, and a lack of education regarding self-identification all contribute to the risks nurses face. “There are a lot of risk factors that are unique to nurses that weren’t being discussed in the education that the students were getting,” said Dina Stewart, RN, a Doctor of Nursing Practice student who worked with Christine Mueller, PhD, RN, FGSA, FAAN, associate dean for academic programs, and others to develop a learning module for all pre-licensure students. “It’s largely something nurses don’t talk about still because of the stigma.”

The module, which will be made available to pre-licensure programs across Minnesota, is designed to help students understand the risk factors nurses face, with the idea that if nurses know their risks they are better equipped to avoid them. Another objective is to give emerging nurses a plan of action if a colleague exhibits symptoms. “One of my biggest hopes is that it can be discussed openly without any shame associated with it,” said Stewart.

Many nurses don’t seek help because they fear they will lose their licenses to practice. The education describes the protections in place to assist nurses and other health professionals. Minnesota offers nurses and other health professionals a confidential monitoring program. “Nurses are worried they are going to lose their livelihood when really there are protections in place to assist them if they come forward on their own,” said Stewart.

Introducing peer support for nurses in recovery

The goal is that the education being taught in the classroom will be bridged to extend to orientation and ongoing professional development in practice settings. Until recently, nurses who sought treatment and hoped to re-enter the profession had little assistance from each other. Nurses in Minnesota now have a peer support network, which works to foster peer support for nurses in recovery.

The meetings do not take the place of treatment or AA, but rather provide an opportunity for nurses to talk about their recovery and the challenges unique to nursing. “The main hurdles are stigma and shame. That’s especially true in nursing because we are dedicated to helping people and when we realize that we may have harmed people, the shame of that is overwhelming,” said Marie Manthey, RN, Nurses Peer Support Network board chair. Manthey’s own story of recovery is shared in the School of Nursing’s module.

Regular meetings of the network are held in eight cities across the state, and on any given week, there are 10 to 15 people at each meeting. Plans are underway to expand to more cities. “We would like to have meetings in every area where there are groups of nurses who would benefit from it,” said Manthey, a School of Nursing alumna.

Reflecting on the progress made and the work still to be done, Dean Delaney credits the group’s collaborative spirit and willingness to be vulnerable during difficult conversations for its successes. “What’s underlying the development of this integrated model, ultimately, is ensuring the highest trust and safety of the public and also supporting our professionals,” said Delaney. “The way to enhance the health of the public is ensuring the health of care providers, including nurses. We have the framework and we are committed to build on it.”

Substance-Use Disorder Awareness added to UofM SON Curriculum April 20, 2017

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House of Charity generously supports MinnPost’s Mental Health & Addiction coverage; learn why

With high-stress jobs and access to sometimes-addictive medications, some nurses are at elevated risk of developing substance-use disorder.

The very real issue of substance-use disorder among nurses isn’t something that gets talked about all that much in nursing schools. A new curriculum created by the University of Minnesota School of Nursing and made available to nursing schools around the state is trying to get that timely conversation started.

It’s almost as though the profession has been avoiding talking about the issue, said Christine Mueller, RN, Ph.D., associate dean of academic programs at the U of M School of Nursing.

“If substance-use disorder gets talked about in nursing programs at all, it is usually very superficial,” she said. “At the University of Minnesota, prior to the development of this curriculum, we had not been intentional about making sure that this was an official part of the conversation. But now we’ve created a way to devote an entire class session or online module to the topic. ”

This focus is important, Mueller added: “At the end of the day, substance use disorder among nurses is a quality and safety issue for patients, and we have a big focus on patient quality and safety in our program.”

With high-stress jobs and access to sometimes-addictive medications, some nurses are at elevated risk of developing substance-use disorder, Mueller said. Though at an estimated 10 percent, the rate of addiction among nurses is no higher than in the general population, the risks of coming to work impaired or diverting patient medication could put lives on the line.

Jace Gilbertson, a senior in the U of M’s BSN program, said that nurses with addiction issues sometimes find themselves in a particularly tough spot. And it’s not something they warn you about in school.

“As nurses, we are right there on the front lines,” Gilbertson said. “When I finish my degree, I’ll be working in an emergency department. That is a chaotic environment where things happen fast and the stress levels are high. In the nursing profession, there is that stigma and shame around the idea of substance use, but by just being a nurse we put ourselves at a higher risk of coping with stress by using medications and alcohol. Being open about that risk could help stop a lot of problems before they get out of hand.”

Designed to respond

The curriculum, which was developed by Mueller and Dina Stewart, a University of Minnesota doctor of nursing practice (DNP) candidate, was “prompted by the fact that there had been some press about nurses who have substance-use disorder and the role of the Board of Nursing plays in this issue,” Mueller explained. “Our school decided to be proactive and work with the Board of Nursing and others to think about what we could do together to address the issue of substance-use disorder in nurses. One very obvious thing that a school of nursing could do is to ensure that our students are knowledgeable about the topic. That’s where our new curriculum came in.”

Christine Mueller, RN, Ph.D.

Christine Mueller, RN, Ph.D.

The curriculum was added to the University’s degree program this semester. Other nursing schools around the state are also in the process of incorporating it into their programs.

The curriculum’s goal, Mueller explained, “is for students to develop an awareness about substance-use disorder in nurses and about the risks that substance use creates.”

Mueller said that she and Stewart designed the module in part to provide answers to common questions that nursing students ask, including “Why are nurses more at risk for substance-use disorder? What can nurses do to mitigate that risk? What can a nurse do if they come in contact with colleagues that have substance-use disorder? How can you recognize the problem? What is your responsibility if you suspect diversion?”

The format worked well for Gilbertson.

“In this module, we learned how to recognize the signs and symptoms of an impaired nurse,” he said. “We learned it is not a punitive thing to report a colleague if you suspect substance use — it is for the benefit of that nurse to help them get he help they need and put the patient first. It puts the integrity of the profession front and center.”

Real risks — and help

The curriculum also provides important information and warnings about the real risks of substance-use disorder for nurses and their patients.

“We try to help students understand the consequences,” Mueller said. “If you come to work impaired, you could lose your job or you may not be able to work until you deal with the problem. If you get to the point where you divert medication, that is a felony, and you can’t practice in this state if you have been convicted of a felony.”

This information hit home with Gilbertson, who sometimes struggles with what he sees as a pressure for perfection within the profession.

The curriculum helps nursing students step away from the myth of the “perfect nurse,” he said: “As nurses we re not immune to suffering from substance-use disorder, even though we are some of the most trusted people in the hospital. As our patients’ advocates, we have to be strong all the time and not show any weakness. Because there is a stigma around substance use and addiction problems, nurses try to hide their addictions. That’s when things can get dangerous.”

Jace Gilbertson

Jace Gilbertson

The course also includes a recorded interview with University of Minnesota School of Nursing graduate and substance-use disorder advocate Marie Manthey. In the interview, Manthey tells the story of her own struggle with substance use when she was a practicing nurse.

“Marie’s story really brings it home for students,” Mueller said. “She does a great job explaining how substance use can be so insidious in the profession.”

Through Manthey, students also learn about the Nurses Peer Support Network, a program designed to help nurses recover from substance-use disorder and support them in their recovery.

“One of the most important things for new nurses to understand it that substance-use disorder is a disease, not a moral deficit,” Mueller said. “People can recover from this. We try to make that point clear in the curriculum.”

Realizing that it is possible to recover from substance use disorder and continue working in the nursing profession was an important realization for Gilbertson.

“There are steps a nurse can take to be rehabilitated from substance-use disorder,” he said. “It is reassuring as a nurse going into the profession to know that there is a safety net and there are people out there caring for you.”

Part of closing course

At the U of M, the new curriculum is now a required element of the program’s final “Transition to Practice” course. Mueller explained that the placement was intentional, serving as a key introduction to the realities of life as a working nurse — and as a reminder of the importance of being aware of the risks that substance-use disorder creates.

“It made a lot of sense to place it in our curriculum in the last semester or the last year of the program when students are beginning to think about transitioning to practice,” she said.

Gilberson agreed.

“I think the curriculum is placed well,” he said. “It’s a good reminder of how we should be taking care of ourselves as we go into the profession of nursing, a good call to action for nurses just entering the workplace, a good opportunity to teach nurses early on that this is a reality that they may face during their careers.”

A Wise Woman Once said….A Celebration of Florence Nightingale’s Legacy May 12, 2010

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A wise woman once said: “It is fundamental that the hospital shall do nothing to harm the sick.” This woman then went on to create what has become in modern times, the profession of nursing. She instinctively recognized the eternal truth of the phrase “To whom it is given”, to care for the sick and to found the profession of nursing – based on the equal strengths of knowledge and compassion.

I often think about Florence Nightingale’s legacy using the metaphor of a seed. Within every seed are all the qualities and characteristics of the entity that is to grow from the seed. Not all qualities and characteristics are nourished and grow equally. Some grow quickly, others much more slowly. And so it is with Nightingale and nursing. In celebrating her life, and its meaning for nursing and for the world, the qualities and characteristics she embedded in the profession deserve to be recognized, both those that flourished and are strong today, as well as those that have yet to be developed. http://en.wikipedia.org/wiki/Florence_Nightingale

Some of Nightingale’s strongest qualities are that she was an intellectual, environmentalist, statistician, politician, administrator, spiritualist and hands-on caregiver.

Nigthtingale’s intense spirituality is made evident in a book of her letters written to her family while on a three month tour of Egypt and Greece. She was not so much religious as she was spiritual. I was amazed to learn that she studied every religion, including paganism, since she believed any one of them could bring her closer to God. Her passion to serve the sick is a direct result of her spiritual life.

As is well-known, Florence was a lady of highest standing is society. Her parents were wealthy. In fact, after their wedding, they embarked on a six year honeymoon tour of the world. They named their first child, Florence, after the city she was born in and their second, Parthenon, for the major tour feature of the city where she was born.

Florence knew early in her life that the role society assigned to her was not acceptable to her. She was highly intellectual; a quality that resulted in her being taught by her father. She learned subjects not generally understood by women like geography, mathematics, politics and world history. She rebelled against her family’s and society’s beliefs about the role of women in the upper classes and eventually, with enormous struggle and cost, prepared herself as a nurse. She believed in the depth of her soul that this was God’s will for her.

Her skill as an administrator became evident when she was commissioned to nurse English soldiers in Scutari. She understood the value of resources and how to use them to accomplish a goal. When the Army Surgeons refused to allow the nurses access to the hospitalized soldiers, Florence withheld access to the ship full of supplies. She managed to withhold access to them until the surgeons relented and invited the nurses to come and work in the hospital. So not only was she an administrator, but also a politician. She analyzed and used the “pockets of power” in any situation. Today, nurses have well-developed administrative skills, but we still need to sharpen our political acumen.

Another interesting strength of Nightingale is in her use of statistics. In contrast to modern nurses, Nightingale loved the field of statistics and was quite creative in her use of numbers. She actually reformed the British military health care system by demonstrating statistically a dramatic drop in mortality rates when soldiers were in the care of nurses. During the war that statistic went from a 43% death rate to a 2% death rate due to the incredible reforms in hospital care she pioneered. Speaking of pioneering, the field of statistics considers Florence one of their pioneers as she created the first pie chart that clearly shows metric relationships among various segments of a whole. Several years ago the magazine, Science News, ran a feature on Florence as their pioneer, showing her on the cover with a replica of one of her pie charts. http://www.sciencenews.org/index/generic/activity/view/id/38937/title/Florence_Nightingale_The_passionate_statistician

Nightingale’s life reflects a wholesome integration of intellect and spirit. She was brilliant; considered a mystic – one who has received a revelation directly from God. As I read Barbara Dossey’s book about Florence’s life, I was amazed to learn she wrote and spoke in five languages. She even made notes in her bible in five languages, which meant she could actually think in different languages. http://www.dosseydossey.com/barbara/book.html

She walked among the pallets in the rat and vermin infested hospitals for the lowly foot soldiers, whispering words of encouragement and hope to the suffering soldiers. She embodied the twin values of knowledge and compassion. The lowly soldiers nicknamed her “The Lady with the Lamp.” They told their parents and families about this remarkable woman. Word quickly spread throughout England that “a high-class lady” was saving lives in Crimea. Grateful parents began donating small sums of money to what eventually became the Nightingale Fund. Florence used this money to start the first modern school of nursing at St. Thomas Hospital. Therefore the profession of nursing as we know it today was funded, not by the health care system, but from outside sources.

One of the criteria used to differentiate a profession from an occupation is that a profession is based on a system of values so fundamental to the nature of mankind that those who hold them can be said to profess to them, as in witnessing. Thanks to the seeds planted by Nightingale, nursing has just such a system of values.

Deeply embedded in the profession of nursing is the belief that of all the forms of human interaction, that of one human being helping another is of high value. Such a simple concept, and yet so rare in modern society. We live in a world today that values competitiveness over cooperation; winners are “better” than losers, which rewards aggressive behaviors in the conduct of daily business affairs and that condones violence as an appropriate way to address wrongs.

We work in institutions that are run as businesses, where profitability trumps all other values. Where putting a price tag on the value of nursing has been an elusive goal. I’m sure Nightingale is proud of Linda Aiken’s research showing that when there is a higher ratio of RN’s to other staff, fewer patients die and there are less complications.

Yet, nursing holds on to the value of one human being helping another. We know the incredible privilege we have when people give us access to all levels of their being: their bodies, minds, spirits and emotions and we cherish that privilege. The public’s trust is reflected in the Gallup polls where nursing is consistently the most trusted profession.

We cherish the privilege of walking into the room of a sick person and being able to interact in a way that alleviates their pain, or increases their comfort. This is an act of nobility and dignity.

Nightingale said nursing is a noble profession; it is up to you nurses to make it noble. There is nothing wrong with our values, even though they are not shared by the system or society. If the world accepted our values, it would be a more civilized world.

Marie Manthey on the birthday of Florence Nightingale.