Now Is the Time

We are living in a world with guns. As much as I would like to change that, as would so many of us, I need to focus on what I can change – and what you and I as members of the largest group of healthcare professionals in the nation can change. I have committed to the following, and I urge you to do the same.

Encourage and conduct research on gun violence.

In a pivotal move to decrease gun violence, President Obama directed the Centers for Disease Control and other scientific agencies to research its causes and prevention. The President’s directive lifts a de facto 17-year ban on federal research on gun violence research. “We don’t benefit from ignorance,” he said in releasing his plan “Now Is the Time”. “We don’t benefit from not knowing the science of this epidemic of violence.”

Dr. Therese Richmond, our leading researcher on violence, and other prominent researchers at Penn are positioned to work across disciplines to systematically build a science on lowering injury and death from gun violence.

Science can help keep people safe from injury and death by providing data and evidence for policy changes. We have a tremendously effective model in motor vehicle safety. When we learned that people were dying in car accidents, we did not get rid of all cars. Instead, with data and research findings, policies to enhance the safety of cars were implemented and continue to save lives. If we accomplished that with car crashes, we can accomplish that with gun violence. And nursing research must be front and center.

Change perceptions about gun violence.

Gun violence is a health issue and central to what we in nursing should care about. What happened in Newtown, CT, was tragic, and so is the gun violence that kills children and adults every day in every U.S. state. And, it is a hard truth, but when the victims of violence are brown and black, our society doesn’t pay as much attention, yet gun violence is the leading cause of death of African Americans ages 15 to 24.

Gun violence kills Americans in mass shootings that grab hearts and headlines, and gun violence kills Americans one by one every day on street corners and in homes. Four million Americans have been injured by guns in the past 30 years and approximately 30,000 die every year from guns. We cannot view the Newtown school shooting as an isolated event, nor should mass shootings be the only impetus toward action. Gun violence is a daily occurrence in the U.S., as sure as the rising and setting of the sun.

Become familiar with the facts.

Since we are not all experts in this area, what should we know and do? As nurses, we all should be conversant about the facts related to gun violence. Dr. Richmond is research director of the Firearm and Injury Center (FICAP) at Penn. FICAP has developed the fact sheet “10 Things Every Healthcare Professional Should Know about Firearm Injury.” It is evidence-based and a must-read for us all.

As President Obama said, “While we may not be able to prevent every senseless act of violence in this country, if there’s even one thing that we can do to reduce it, if even one life can be saved, we’ve got an obligation to try.”

When it comes to this socially complex, polarizing problem, the worst we can do is nothing. Nursing as a profession and nurses as individuals are committed to health and well-being, therefore a focus on enhancing the safety of people and eliminating all forms of violence, including gun violence, is part of our mission. Now is the time.

We as nurses care for people, families, and communities who trust us. We should employ that trust and data and facts to educate and to change perceptions about injury due to gun violence. We should act by engaging in research programs to reduce injury and death from gun violence. We have the courage to act, the expertise to conduct research, and the compassion and caring to change the world.

Confronting the Human Costs of Alzheimer's

Countless numbers of us have experienced the devastation of Alzheimer’s disease. As I did with my own mother, we have watched with increasing frustration as someone we love slips away day by day without comprehension, control, or comfort, and we have often felt powerless to help. Hope has been in short supply.

But it was with a tremendous feeling of hope that Dean Larry Jameson and I welcomed a group of some 50 Alzheimer’s disease luminaries to the University of Pennsylvania in June for the Marian S. Ware Alzheimer Program Invitational Summit, co-hosted by Penn Nursing, Penn’s Perelman School of Medicine, and The Campaign to End Alzheimer’s Disease by 2020. The conference, dedicated to the state of the science of Alzheimer’s disease, was sponsored by the Marian S. Ware 2006 CWG Charitable Lead Annuity Trust with support from Penn Nursing alumna and Overseer Carol Elizabeth Ware. In Penn’s historic Houston Hall, experts from academia, industry, and the care and philanthropic communities came together to map out a strategy to implement the “National Plan to Address Alzheimer’s Disease,” which was released this spring by the United States Department of Health and Human Services. Conference leaders will produce a paper with specific recommendations for the plan.

The take-home message from the meeting was one of urgency to envision and implement both long-term solutions in the form of new treatments and prevention measures as well as more supportive and holistic care options for patients and caregivers. With Dr. Jason Karlawish of Penn’s Perelman School of Medicine, Dr. Mary Naylor, the Marian S. Ware Professor of Gerontology and director of the NewCourtland Center for Transitions and Health at Penn Nursing, led the conference. Dr. Naylor’s work in transitional care holds great potential for patients with Alzheimer’s disease and their families. She and others who participated in a work-group on clinical care and health services research continually reminded their colleagues to keep in mind the human costs of the disease and the needs of patients and families from the time of initial recognition that something is wrong, through the inexorable decline in cognition and physical function, and finally to the end of life.

This conference represents a watershed moment in worldwide efforts to confront what eminent Alzheimer’s researcher Dr. John Trojanowski called the “silver tsunami” of aging in our global society. Working together, across disciplines, institutions, and geographical boundaries, we will indeed find solutions to the challenges we face throughout the full care-to-cure spectrum.

The Power of Nursing Science

Nursing is a discipline that affects people one-by-one, community-by-community, and nation-by-nation. As nurses, we take seriously our moral commitment to the world to work toward the health and well-being of individuals and populations.

I recently participated in an initiative called the Global Advancement of Practice and Research in Nursing (GAPRIN), which was co-sponsored by the U.S. Department of State and the National Institute of Nursing Research (NINR).  I was one of two leading U.S. academic nurses invited to travel with a delegation to Bangladesh where nurses, for the first time, were invited into the boardroom to join discussions with health care leaders from around the word. Our purpose was to empower and catalyze nurse leaders to guide others in creating an evidence based culture and a more person centered approach to health care.  We met with governmental officials, academicians, and clinicians to discuss the importance of building strong nurse training programs in research and clinical practice that evolve into lifelong career paths for nurses. The outcome was remarkable.

In developing nations like Bangladesh, the concept of nursing research is novel, even unheard of. After hearing about the significance of nursing research in producing the evidence for quality care, the Executive Director of ICDDR,B (International Centre for Diarrheal Disease Research, Bangladesh), Dr. Alejandro Cravioto, committed $25,000 for competitive proposals in nursing research – the first such funding for nursing research in Bangladesh. The NINR and the U.S. Department of State will support nurses in Bangladesh in developing research programs as well as in empowering nurses to use evidence in their practice.

Together we will start to build an aspect of nursing that is critical for Bangladesh and for every country in the world – the capacity for nursing science.