Nursing faculty and nurse leaders influence today’s headline issues
Rory Meyers College of Nursing (NYU Meyers) under the leadership of Dean Eileen Sullivan-Marx, PhD, RN, FAAN is committed to educating lifelong learners, who will excel in their nursing careers and be recognized as leaders, keeping patient-centered care and the health of society at the forefront. NYU Langone Health is one of the nation’s premier academic medical centers. Its trifold mission, to serve, teach, and discover, is achieved daily through an integrated academic culture devoted to excellence in patient care, education, and research. Kimberly Glassman, PhD, RN is NYU Langone’s senior vice-president for patient care services and chief nursing officer, associate dean for partnership innovation at the college, and an NYU Meyers alumna.
Nursing faculty from NYU Meyers and nurse leaders from NYU Langone Health collaborate on influencing current health issues, providing innovative solutions pertinent to nursing practice and patient care. Two issues occurring daily in headlines across the country, the opioid epidemic and workplace harassment, call for the professional collaboration evident at NYU Meyers and NYU Langone Health.
Addressing the opioid crisis requires the coordinated responses of all health care providers and U.S. registered nurses (RNs), numbering 3.6 million. Increasingly nurses are the leaders tackling this epidemic, developing opioid prescribing guidelines and protocols for implementing them, using non-opioid treatments, preventing overdoses, increasing access to opioid addiction treatment, and preparing nurses and other health care professionals to intervene, treat, and curtail associated problems.
Schools are now stocking naloxone, also known as Narcan, a medication that can reverse an opioid overdose. Just as school nurses have been empowered to stock and use EpiPens to prevent severe allergic reactions, they are now keeping Narcan in their offices and obtaining continuing education on how to administer it.
Medication-assisted treatment (MAT), the use of medication to treat substance use disorders, is now recognized as a critical component in responding to the opioid epidemic. Methadone and buprenorphine have been shown to be effective in treating opioid use disorders primarily by increasing readiness for treatment through preventing and reducing withdrawal symptoms.
In July 2016, President Obama signed the Comprehensive Addiction and Recovery Act into law, which expanded buprenorphine prescribing privileges to nurse practitioners and physician assistants. This expands the pool of providers significantly and makes treatment more available.
The Center for Drug Use and HIV/ HCV Research (CDUHR) at NYU Meyers is co-directed by Sherry Deren, PhD and Holly Hagan, PhD, RN, MPH, a nurseepidemiologist and leader in the field of substance use and its infectious disease consequences. The NIH-funded Center focuses on research and disseminating evidence to support practice and policy development.
Dr. Hagan is currently investigating an upstate New York population of young adults who progressed from taking prescription pills to injecting drugs like heroin. Preliminary findings show that half of the study’s participants had been physically, sexually, or emotionally abused as children, and that prescription users were more likely to switch to heroin if others in their social circles were already injecting.
As an associate director of CDUHR’s Core on Implementation and Dissemination, this author worked with members of the Psychiatric-Mental Health/Substance Abuse Expert Panel of the American Academy of Nursing to produce the organization’s policy statement on the opioid misuse epidemic. Practice needs to change if the epidemic can be curbed and further abuse prevented. While the #MeToo movement has highlighted disruptive behavior and harassment in the workplace in entertainment, the arts, and media, little attention has been paid to the national problem of nurse abuse and bullying. Nursing remains a predominantly female profession and reflects higher rates of sexual harassment, emotional abuse, and bullying toward women. Nurses identified as minority group members (whether race, gender fluidity or sexual orientation) are subject to abuse and harassment at even higher rates. The prevalence of bullying and verbal abuse toward LGBT nurses has been described by NYU Meyers Professor Fidelindo Lim, noting in Nursing Management (August, 2016), that we need to educate nursing staff to deal with abusive comments from the public and co-workers as well as to support persons who may be targeted. The American Nurses Association’s website (nursingworld.org) advocates for inclusive policies to address abuse and bullying and highlights the workplace pressures that can lead to bullying, incivility and violence. Nurses can lend their support to ending abuse and bullying in the profession by Taking the Pledge to #End NurseAbuse at www.americannursetoday.
Locally, a more immediate evidencebased policy is now in effect at NYU Langone Health. Building on the recent nursing research of NYU graduate Ron Keller, PhD, RN, the medical center supports the program— ullying
na It provides tools for participants to identify signs of bullying, support peers, and ultimately help eliminate bullying in the workplace. Keller’s study findings suggest that certain individual and workplace characteristics predispose early career nurses to verbal abuse by their colleagues. These include being divorced, widowed, or separated (marital status); practicing as an Advanced Practice Registered Nurse (role); working in hospitals vs. ambulatory care (setting), and working evening shift (alternative work schedules). Four other predictors also proved significant: negative affectivity, organizational constraints, distributive justice, and workgroup cohesion.
The BE NICE program reflects ANA’s position that an ethical, moral, and legal responsibility should shape a healthy and safe work environment for all members of the health care team. Six months after BE NICE was initiated at NYU Langone Health, multiple nurses reported situations in which this approach was successful in identifying and eliminating workplace bullying.
To make the changes necessary to address the opioid epidemic, workplace harassment, and bullying nationwide, both social and professional responses are required. Change from the ground up requires leadership and evidence.
— Madeline A. Naegle, PhD, RN, CNS-PMH, BC, FAAN; NYU Myers Professor & Director, PAHO/WHO Collaborating Center for Geriatric Nursing Education, Health
and Aging Policy Fellow, 2016-2017