Judy McDaniel RN, MSN

I don’t know when I decided I wanted to become a nurse; my family says it’s all I ever wanted to be. But how I became a nurse was not the typical course you would expect. I was only 17 when I started nursing school. I had never been a patient; being a candy striper was my only experience in a hospital. Ready to work as a nurse I was not. This was the path for the majority of nurses in the 1980s.

I am an overachiever (most nurses are), so the first year in nursing school was easy. I did well although I struggled with time management, prioritization, and knew nothing about critical thinking. At the ripe old age of almost 19, I thought I was ready to talk with physicians as peers, tell patients that I understood what they were going through, and sit and empathize with someone who had lost a loved one. It was during the first semester of my last year that I realized I wanted to do more than the tasks typically associated with nursing. I wanted to care, attend to and nurture others. My goals and the reality of nursing were not the same, so I did not finish school.

Fast-forward four years — I was older, had more experience and a stronger drive to fulfill my dream of becoming a nurse. No longer did I struggle with time management, or lack empathy to help someone through a stressful situation. I went back to the same nursing program and graduated nursing school in 1982; earned a BS in 1994; and an MSN in 2007. I have also taken countless hours of continuing education courses, so you could say I am a life-long learner.

Learning is always possible — regardless of your age. Today the average age of a nursing student is 43. I read one interview of a 47-year-old male nursing student (talk about non-traditional student), who made some good points: 1. Non-traditional students bring their life experiences to nursing, which help with critical thinking and decision-making abilities. 2. They are closer in age to the current workforce, which helps them assimilate into the nursing unit. Many older students are going into nursing as a second career, so they also bring their professional experience into healthcare. We already know that many other professions have good ideas that nursing has adopted, such as crew resource management – TEAM STEPPS.

Even though I am a late baby-boomer, I still have many good years to work at the bedside and in other areas of nursing, such as education. I currently help nurses by working to provide quality continuing education for those who are looking to change their career to nursing. They can find information about many new areas in nursing such as risk management, informatics and professional development. I also train new nurses in simulation to help them transition into the hospital setting, and it has helped to keep them engaged and has reduced stress. With all the changes that are happening in healthcare today, non-traditional students can help transition these changes into practice.

Are there challenges to starting nursing school at a non-traditional age? Absolutely. Trying to juggle family, home, work and school all at once was incredibly challenging as a traditional student. I remember wondering how the non-traditional student managed all they had because I struggled just to care for myself and complete my schoolwork. But as Laurie Round, vice president of patient care services and chief nursing executive at Advocate BroMenn Medical Center in Normal, Ill., said, “These people are choosing nursing while raising a family and working at the same time and that shows perseverance, commitment and discipline.”

So if you are a baby boomer or Gen X, there’s a place in nursing for you. Your past work experience, dedication and passion are all needed resources within the healthcare arena. As Uncle Sam once said, “We Want You!”

Tell us how you became a nurse in the comments box below.

Phyllis Class, RN

My friend’s 15-year- old son logged 9,000 text messages last month. Nine thousand. And in between sending and receiving these text messages, he’s been begging his dad to teach him to drive. I’m scared to death.

Needless to say, I’m not the only one who’s alarmed. Researchers at Cohen Children’s Medical Center in New York reported earlier this month that more teens now die from accidents caused by texting than those caused by drunk driving. If that’s not scary enough, another study published this month in Pediatrics showed that about half of teenage drivers text while driving. Those who do so are more likely to engage in other risky behaviors like not wearing their seat belts or drinking while driving.

But wait a minute. Teenagers aren’t the only distracted drivers on the road. Last weekend, we passed an adult driver on the Florida Turnpike who was scrolling or surfing on a smartphone. How often have you glanced over to see a driver whose eyes are glued to his cell phone?

The statistics are sobering. According to the National Highway Traffic Safety Administration, 3331 people were killed in 2011 in accidents involving distracted drivers. In 2010, nearly one in five accidents involved a distracted driver. And In 2011, 196 billion text messages were sent and received in the U.S., up nearly 50% from 2009. That’s right, I said BILLION!

Consider this for a moment: According to the Ad Council on Texting and Driving Prevention, a texting driver is 23 times more likely to have a car accident than a driver who’s not texting. The average text takes a driver’s eyes off the road for five seconds.

So what’s being done about this growing problem?

Florida just became the 40th state to ban texting while driving. However, it’ll be a secondary violation. In other words, an officer can’t pull you over for texting; you have to also be speeding or committing some other infraction. And the jury is still out on the effectiveness of these statutes.

A large cell phone company is weighing in on the issue. AT&T’s It Can Wait ® campaign asks people to take the following pledge:  “No text message, email, web site or video is worth the risk of endangering my life or the lives of others on the road. I pledge to never text and drive and will take action to educate others about the dangers of texting and driving.”

No law or pledge can make people stop this dangerous behavior, but they’re a start. Perhaps the best thing you can do to stop people from texting and driving is to set a good example. Teach your kids not to text and drive and don’t do it yourself. Ever!

Susanne J. Pavlovich-Danis, RN

Advanced practice registered nurses (APRNs) have prescriptive authority in nearly 50 states. It’s one of our most important responsibilities, yet it places us at risk for malpractice and puts our patients at risk for medical misadventures. If you haven’t heard the news yet — our recertification requirements are expected to change dramatically in 2014 to reflect the importance of our pharmacotherapeutic responsibilities.

I am certified by the American Academy of Nurse Practitioners (AANP) and my new requirements after 2014 have yet to post on the organization’s website. More than likely, they will be in line with the new American Nurses Credentialing Center (ANCC) recertification requirements that require 25 contact hours of pharmacotherapeutic continuing education. The new requirements stem from the APRN Consensus Model that includes national uniformity among APRNs in credentials, scope of practice, and educational and state regulations as a way to improve access to high-quality, cost-efficient care that we provide.

You may be surprised to learn that data from the Centers for Disease Control and Prevention (CDC) revealed that more than 75% of all healthcare visits involve prescription drug therapy and many of the patients we see engage in polypharmacy — placing them at great risk for adverse outcomes. Even if your practice does not include extensive prescribing, chances are the patients you care for will be prescribed multiple medications that potentially will impact how you care for them. I’m sure if your patients are like mine they arrive to their appointments with a wealth of information they’ve found on the Internet about medications they believe are right or wrong for them.

Regulations have changed how the pharmaceutical industry interacts with healthcare providers. Pharmaceutical representatives no longer line up at my door armed with information about their products, including drug monographs, educational discs, and patient and provider teaching aids to introduce new drug options and pique my curiosity to learn more. Now, I’m asked to go online, request my own samples, and seek out new drug information on my own. It’s a time-consuming process. I’m sure you also receive an abundance of print materials and magazines to sift through in addition to being bombarded with television and radio advertisements about the latest drugs. To me, it’s information overload with limited usable information to guide prescribing.

Many of my certified APN colleagues may only discover the new ANCC recertification pharmacotherapeutic education requirements when they log in to their certifying organization’s site, anticipating that they have already completed everything they need to renew. I expect that some of those colleagues will experience much anxiety and scramble to earn the required pharmacotherapeutic hours at the 11^th hour.

You can earn 25 pharmacotherapeutic continuing education contact hours by completing the Advanced Practice Nurse Pharmacology course. This course provides detailed, drug-related information for chronic and acute medical and mental health conditions. Whether you work in an inpatient, office or community-based setting you’ll find useful tips for medication prescribing and monitoring. Join me and complete your requirement early — and check one more thing off your “to do” list!

Jan Lynch, RN

As we celebrate our 25^th anniversary at Nurse.com, we are speaking with nurses of excellence who have made significant contributions to the profession over the past 25 years. I had the wonderful opportunity to speak with Dr. Margaret L. McClure. She is a humble and amazing person who possesses grace and a warm sense of humor. Let me tell you a little about this wonderful nurse!

Dr. McClure is an adjunct professor at New York University. For almost 20 years, she was the chief nursing officer at New York University Medical Center, where she also served as the chief operating officer and hospital administrator.

She is currently involved in several national projects, most notably an effort designed to create a seamless educational path for new nurses entering the profession, funded by the Robert Wood Johnson Foundation and the Jonas Center for Nursing Excellence.

Early in her career, Dr. McClure recognized the importance of making administrative decisions that were right for patient care, and she said it has influenced everything she has accomplished. For example, in the mid-nineties when lengths of stay began to drop, she established the first residency program for new graduates with the goal of assuring that these nurses would have carefully supervised clinical experience before taking positions in more independent community settings.

As a member of the College Deans and Directors group, she was involved in creating the 1985 legislative proposal and had the opportunity to work with other renowned nursing leaders and speak about nursing education throughout the country.

Dr. McClure was invited to join the American Academy of Nursing in 1976, and as chairperson of the academy’s taskforce, McClure coauthored the ground-breaking study, “Magnet Hospitals: Attraction and Retention of Professional Nurses.” She also served a three-year term on the Commission for Magnet Hospitals, which established Magnet standards and criteria.

“The Magnet hospital program has pushed us to develop evidence-based practices and nursing research, and like a rising tide, it has raised everyone’s practice and standards,” she said.

Dr. McClure credits the many mentors who influenced her in making key professional decisions, such as pursuing patient care services, continuing with advanced degrees and getting involved in organization and policy work.

“With my colleagues and bosses, there was a mutual mentoring relationship, where we knew we could turn to one another for advice and knowledge. Certainly, it is important to say to others, ’Can you give me some help,’” she said. Dr. McClure also remembers her parents as great role models in her life.

Because of her remarkable contributions, she was named a living legend by the academy in 2007. She is a great nurse among us who continues to make remarkable contributions, and I am so grateful to Dr. McClure for all that she has done for us!

Robert Hess, RN, PhD, FAAN

Several times in my career I sat where you are, at the end of one journey, ready to begin the next. I know how hard it is to juggle your personal life with the student role, and I admire you for successfully negotiating it. I was happy to finally be done with school. However, although this graduation is a landmark in your education, it’s probably not the last. You need to become life-long students, one way or another.

What I think you need to know and what you want to know is this: You are about to reap the gains of one of the best decisions you’ve ever made in your life. Sometime in the past, you decided to go back to school, and you had a dizzying array of choices. One thing you can bet on is that the program you selected changed your life in some way. By picking Seton Hall University, you’ve won a career lottery. You have a world-class career foundation, an edge that many don’t have.

Almost 40 years ago, my diploma school had prepared me to enter a measured, serene terrain with comfortable choices. But the land through which you guide your careers is frenetic and supercharged — a retooled, cyber-enhanced frontier that has blasted us out of complacency to create new opportunities for healthcare professionals that are not even clear to our own leaders. But you can trust that your program has prepared you well.

And you are entering a land of plenty. As consummate career strategists, you are gunning up your careers just when the most uncertain nursing shortage in the history of America will boil to hot frenzy. For years, researchers have predicted a shortage 4X bigger than any other. Now with a recent surge of younger graduates, a delay in retirement by older nurses, and a looming consumption of healthcare by an aging population, no one knows what’s going to happen. But one thing is certain, a huge horde of baby boomers, read Bob Hess, is going to need you.

About 30 years ago, I was a master’s student in nursing administration at Seton Hall, taking classes in the evening with a world-class faculty and applying what I learned during the evening to my day job as a nursing director, the best of all possible worlds. So by the time I graduated, I had already gained a sizable store of knowledge and expertise. For good measure, I stayed on for a while as faculty, while my career soared, mostly because of Seton Hall.

Six years later I went back for another degree. For some of us, formal education doesn’t end until a terminal degree is achieved. I was in my 40s and one of the oldest students in my doctoral cohort at Penn. I had to quit my full-time job to complete the core classes. I remember when I got home on the first day, there was a black knapsack on the breakfast room table. I asked my wife what that was for, and she told me, “I want you to look like all the other kids.” I tried to fit in. For those of you who completed the DNP & PhD programs, I hope you’re proud. It was one of the hardest, but most rewarding things I’ve ever done in my life. Because of that degree, doors that I didn’t even know were there opened.

But there are doors that you don’t want to know about. Like walking into a hospital as a patient, and believe me, being a nurse does not prepare you to be one. That was evident to me even before I got to Cooper University Hospital, Camden, NJ for the repair of my abdominal aortic aneurysm this past February. As a former critical care nurse with years of experience, I began to ready myself for this not-so-elective procedure days in advance — on a conceptual level only, that is, as I found out when I was admitted.

I’m a happy, half-full kind of guy, but when the anesthesiologist approached me and said he wanted to take me into a room and put something like an IV into my artery, I almost bolted. “You want to put an art line in me?” I squawked.

As the reality set in that I was about to become a critical care patient, I was somewhere between anxious and terrified, but I did as my colleagues had advised and gave myself over to the process and professionals in place. I’m glad I did.

I’ve had a lot of procedures in the past few years, trying to stay healthy and live forever like the rest of my baby boomer friends. The striking component of my patient experience has been the nurses. I’ve not encountered a nurse who wasn’t everything I idolize in my profession. I’m not naïve — this is just what I’ve experienced. With the aneurysm, the nursing care I received was expert, effective, caring, and phenomenal. I can be a great critic when it comes to nursing and uniquely situated to judge, according to me. In particular, Holly, simply a great nurse, took care of me for 12 long hours through the night of my operation. I had a few glitches with preexisting problems and a squirrely mean arterial pressure, about which I hammered her, but she handled those issues and me deftly.  She kept me comfortable, safe, and informed, as she cared for me, a worried nurse caught in the patient role. How great is that? I told her that I’d be carrying her praises around in my extensive national and international contacts for some time. Like many of our colleagues, so focused on her work, she didn’t seem to a care.

But today is about you, and I’m never more proud to be from Seton Hall. As I consume healthcare like a bandit, I give thanks to you for being my colleagues and even more gratitude knowing that some of you might be my nurses. Thanks for that.

I think this is point where I’m supposed to impart points of wisdom, so here are three I’ll leave you with:

1. Never stop learning. Whether it’s continuing education, casual learning, or a formal academic program, you need to go back to school, forever.

2. Life is like high school. Work on being popular. It’s not enough in the professional job market to be smart and credentialed. People hire the people they like.

3. Learn to lead by associating with leaders. Pathways to leadership can be different, but research has shown that the most important element in becoming a leader is the influence of other leaders. Put people with leadership potential around leaders, and they will breed new leaders like rabbits.

The happiest professionals I know are those who are fully engaged in learning, popular with others, and surrounded by the best colleagues. Take these simple truths with your newly minted diploma from Seton Hall University, and you’ll be assured a world-class career. Congratulations.

Martha Tice, RN

Marilyn Tavenner, RN, BSN, MHA, a onetime staff nurse, was confirmed May 15th as the administrator of the Centers for Medicare & Medicaid Services. “I think one of the things that is so critical about how nurses view the world is that you are looking at how do you get everybody involved in the process, whether it’s family, whether it’s staff,” Tavenner said in a February 2012 article on Nurse.com. Tavenner encourages discussion and is open to hearing all sides, but once a decision is made, “we all move forward together.”

Interesting that we can do that for our patients but not for our profession. With Nurses Week behind us, we need to move forward together and address the barriers to implementing a common educational preparation for registered nurses. The ADN/BSN debate has been going on for decades. The conflict negatively affects nurses, the profession and ultimately the people we serve.

There will always be those who excel independent of their educational preparation. That is not the point. Comparing nurses against one another based on educational preparation has not gotten us very far. Patients’ conditions and the healthcare environment are becoming more and more complex so we need to work within the interprofessional team to achieve positive outcomes for our patients. And, the majority of the interprofessional staff has a minimum of a baccalaureate education. Shouldn’t each nurse come to the table with the same credentials? If you believe the nurse is viewed as an equal when the dietitian holds a bachelor’s degree, the social worker a master’s degree, the pharmacist and physical therapist a doctorate degree while the nurse holds an associate degree, you are kidding yourself. Nurses bring a unique blend of psychosocial and physiological knowledge to the mix that no other member of the team possesses. Yet we are often not afforded the same respect as the other disciplines based on educational preparation. Is that fair? Of course not, but fairness has nothing to do with achieving what is best for our patients. And doing the best for our patients is what nurses are about, so we need to act and move past our differences!

The nurse who had the biggest influence on my career was a faculty member of the diploma program I was headed to after high school. I grew up in a rural Kansas family with no college graduates. There were only two baccalaureate programs in the state at the time. One was in the “big city,” the other in a town of 30,000 people — both seemed frightening to a shy girl from a high school class of 60 kids. That instructor talked about the direction nursing was going and encouraged me to take the leap and pursue a BSN. That was over 40 years ago!

Despite my fears, I took her advice and I have been beyond grateful to her for that advice. When I decided I wanted to formalize my clinical leadership role and impact the delivery of care delivered by other nurses, yet not become a manager, the Clinical Nurse Specialist pathway was the ideal way to do that. I didn’t have to worry about finding a way to get a BSN (while starting a family) before applying to graduate school. Her guidance made my professional path so much easier and afforded me so many opportunities that I could not have possibly envisioned at the age of 17.

I know getting an AD can be a financial decision. The fact that the board exam and the license are not different based on educational prep makes it harder for people to consider the baccalaureate path. After all, it was my plan to take the shorter and less scary way to becoming a registered nurse myself. It’s not about individual nurse capabilities, but about bringing the profession up to a common minimum preparation. We help patients and families make difficult decisions daily. Unfortunately, we can’t seem to do that for nursing by phasing out AD programs and making the commitment to one common entry level.

In 2011, 60% of all RN candidates in the U.S. were non-bachelor’s prepared. The course ahead for nursing is going to get more challenging as 1/3 of the nurse work-force is expected to retire over the next 10 to 15 years.* Don’t we want those who remain to be prepared to step into clinical, academic and public policy leadership positions? The path would be much smoother if they enter nursing prepared with a BSN degree.

The Institute of Medicine and Robert Wood Johnson Foundation report on the future of nursing can be found on the IOM website: http://www.iom.edu/reports/2010/the-future-of-nursing-leading-change-advancing-health.aspx.

*The U.S. nursing workforce: trends in supply and education. U.S. Department of Health and Human Services Web site. http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/index.html. Published April 2013. Accessed May 20, 2013.

Nan Callender-Price, RN

Another bad bug has made its debut on the acute and long-term care scene: carbapenem-resistant Enterobacteriaceae(CRE).

Up to half of patients who develop a bloodstream infection from CRE die, according to the CDC. CRE is another potentially lethal bacteria to add to the growing list of malevolent antibiotic-resistant bacteria: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and Clostridium difficile. No surprise — CRE attacks our most vulnerable: Patients whose care requires devices like ventilators, urinary catheters and IV catheters and patients taking long courses of antibiotics are at greatest risk.

The 20th century unveiled the life-saving discovery of antibiotics. Our challenge today is to promote judicious use of them and prevent the manifestations resulting from their overuse. The CDC lists eight core measures facilities and healthcare providers should follow to fend off CRE: hand hygiene; contact precautions; healthcare personnel education; minimizing the use of devices, such as urinary catheters; patient and staff cohorting; laboratory notification; and antimicrobial stewardship. More details from the CDC can be found here.

The CDC’s eight core measures are not rocket science, and we’ve certainly heard them before. With more than 3 million nurses in the U.S., we should be able to stem the rise of CRE and other antibiotic-resistant bacteria. As we celebrate National Nurses Week, let’s remember: Our unique nursing expertise, combined with sheer numbers, has the potential to stop this new bug and others dead in their tracks.

The courses below will help jumpstart your efforts:

CE509, Antibiotic Resistance: The Emergence of ‘Super Bugs’
Provides an overview of the increasing problem of antibiotic-resistant bacteria throughout healthcare and offers strategies for reducing the spread of resistance

CE480, MRSA May Be Waiting Right Around the Corner
Comprehensively reviews MRSA and prevention strategies for this culprit

CE362-60, C. Difficile Threatens Hospitalized Patients
Discusses this relatively new superbug in hospitals and long-term care facilities and offers strategies for reducing its spread

CE651, Vancomycin-Resistant Enterococci: The Battle Goes On
Provides information about VRE in healthcare settings and infection prevention practices to reduce its spread

Eileen Williamson, RN

Did you know that the week we’ve come to know as National Nurses Week  during the past twenty or so years is actually the result of a process that began more than half a century ago, involved several presidents and proclamations, had a variety of titles and dates, and called for numerous Congressional sponsorships, proposals and resolutions? Since it’s May and this special week is almost here, I thought I’d share a little about its history with you.

In 1953, Dorothy Sutherland from the US Department of Health, Education and Welfare made a proposal to President Eisenhower to proclaim a Nurse Day for the following year. The proclamation was not made, but the next year, a National Nurse Week did take place in observance of the 100th anniversary of Nightingale’s Crimean mission. Then a House Representative from Ohio named Frances P. Bolton sponsored a bill for a National Nurse Week, but no action was taken then or during the next two decades. A resolution was presented by the House to President Nixon in 1972 for a National Registered Nurse Day, and still nothing happened. In 1974, after the International Council of Nurses (ICN) proclaimed May 12th as International Nurse Day since they’d been celebrating that day for almost a decade, and President Nixon issued a White House proclamation that designated a National Nurse Week, after which New Jersey worked to make the celebration annual, with Governor Brendon Byrne declaring May 6th Nurses Day, and a private citizen named Edward Scanlon working to promote the celebration on his own.

Then in 1981, the ANA and other nursing organizations rallied to support another resolution from nurses in New Mexico through their Congressman, Manuel Lujan to have May 6, 1982 established as National Recognition Day for Nurses. In February, 1982, the ANA Board of Directors formally acknowledged May 6, 1982 as National Nurses Day, affirming a joint resolution of Congress that had designated May 6th as National Recognition Day for Nurses. On March 25th that same year President Reagan signed a proclamation proclaiming May 6, 1982 National Recognition Day for Nurses.  In one final step in 1990, ANA’s Board of Directors expanded nurse recognition to a week-long celebration, declaring May 6 – 12, 1991 as National Nurses Week. In 1993 they designated May 6 – 12 as permanent dates for National Nurses Week. Some separate days were added later, including May 6th as National RN Recognition Day, and at the request of the National Student Nurses Association, in 1998, May 8th became National Student Nurses Day. Lastly, in 2003, National School Nurse Day began being celebrated on the Wednesday in National Nurses Week each year.

HAPPY NURSES WEEK TO ALL!

Jennifer Chaikin, RN

Have you heard? There is a form of cancer out there that is affecting more than two million of us every year, has a higher incidence than breast, prostate, lung and colon cancers combined, and one in five of us will develop it within our lifetime!

I’m talking about skin cancer. As we all look forward to the warmth of the sun’s rays, we need to balance that fun in the sun with good protection from the damage it can do. The good news is that it is THE most preventable cancer.

My family and I were enjoying time in the sun and in the pool this spring break. We have always been vigilant with the use of sunscreen. My sister was diagnosed with melanoma when she was just 18, myself three years ago, and it runs rampant through my Irish English fair-skinned side of the family.

But this time we found it quite difficult to convince the kids to keep the sunscreen on. (Remember when you could papoose or bribe them and slather it all on? Can’t do THAT now). And the complaints! “I hate the cream! My face looks like a ghost! It’s too thick! I feel sticky! But it’s cloudy!” Ahhh … tweenagers.

So what are parents to do? How can we protect our kids when they need to be outside? Fifteen percent of kids are overweight or obese, so we need to get them outside and moving, right? Is it possible to practice good sun safety and at the same time enjoy a healthy, physically fit lifestyle and have fun without the sunscreen battles? I say yes.

Let’s start with a few facts:

• There is such thing as pediatric melanoma. 90% occur in patients ages 10-19, and while most occur in Caucasians, 6.5% occur in non-Caucasians.
• A person’s risk for melanoma doubles if he or she has had more than five sunburns at any age. One person dies of melanoma every hour.
• Basal cell carcinoma is the most common form of skin cancer.

As I mentioned, my tweens are bucking the rules of sunscreen use. It is not always easy to manage, but I started by informing them that being tan does not mean being healthy. I quickly realized they still might not adapt to the rules and now that they are older, the focus must be less about us protecting them and more on teaching them how to protect themselves. Empower them to be in control of their health.

Here are some ideas:

• It’s like brushing your teeth! Make sunscreen application part of the daily routine. Keep the sunscreen visible and within reach in the bathroom as a physical reminder. With my older daughter, I bought her daily facial moisturizer that has SPF 30. Make sure sunscreen is in their backpacks or equipment bag if the child is involved in outdoor sports activities.
• Self-tanners: New self-tanning lotions and creams look like a natural tan (much less orangey than they used to be) without exposing skin to the harmful UV rays.
• Accessorize! Hats, sarongs, sunglasses!  Let them choose what they like, provided they provide UV protection.

Prevention Basics

Use a water resistant, broad-spectrum (UVA/UVB) sunscreen with SPF 15 or higher 30 minutes before going outside. 
Reapply every two hours or immediately after swimming or excessive sweating. Don’t forget to protect ears, noses, lips, and the tops of feet! Sunscreen alone is not enough, so:

• Seek the shade, especially between 10 AM and 4 PM. Clouds don’t matter. We still need protection. UV rays do come through clouds- no matter what my tweenagers want to believe.
• Do not burn. Unprotected skin can be damaged by the sun’s UV rays in as little as 15 minutes (CDC.gov). However, a lot of us have had the experience of coming in from the sun and THEN noticing the redness. That is because it can take up to 12 hours for skin to show the full effect of sun exposure. So when skin is “a little pink”, its time to get out of the sun.
• Avoid tanning booths. These are bad news. Period. Two to three million teens use tanning booths every year. Just one indoor tanning session increases users’ chances of developing melanoma by 20 percent, and each additional session during the same year boosts the risk almost another two percent. Just don’t let them do it.
• Cover up with clothing, including a broad-brimmed hat (boys may find this difficult, so a ball cap is a good compromise) and UV-blocking sunglasses.
• Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months and those under six months should not be exposed to direct sunlight, as their skin does not yet have protective melanin. Even everyday exposure needs to be considered. Strollers or carriages must have a canopy, infant sized sunglasses and hats should be worn. At the beach? Include proper protective clothing and a pop up beach tent: Coolibar has great items that I highly recommend.
• Examine your child’s skin head-to-toe every month or teach them how to do it themselves. Diagnosis and treatment is delayed in up to 40 percent of childhood melanoma cases, so see your practitioner every year for a professional skin exam.

So the good news is kids can still get outside and enjoy the sun.  We just have to help them be smart about sun safety. The most important thing we can do to help them be smart is to be their role model and advisor. If parents and caregivers practice these rules, it will become part of our kids routine and less of a fight. If you practice sun safety, so will they!

Resources:

The Skin Care Foundation

Skin Quiz

National Cancer Institute

Phyllis Class, RN

From the peaks of Mount Everest to the desert sands of the United Arab Emirates, nurses on the Gannett Golden Triangle and Ranthambore Tour (with pre and post tours to Nepal and Dubai) were treated to a kaleidoscope of different textures and cultures.

Talk about contrasts. On the same day in Agra, India, we visited both the humble Mother Teresa Missionaries of Charities orphanage and the majestic Taj Mahal. We watched people washing clothes at wells in India’s countryside, then visited a hospital with electronic medical records. We learned that malaria, tuberculosis, and leprosy are endemic to India, yet rates of diabetes are skyrocketing due to westernization in urban areas.

Despite these contrasts, Indian nurses appear to have the same issues as American nurses: stress and dealing with physicians’ behavior, to name a few. At one hospital, we heard familiar buzz words like critical thinking and learned that yoga classes are held for nurses’ stress relief. Although the private hospitals we visited look much like ours in the U.S., we observed some differences. For example, we saw visitors removing their shoes before entering the ICU. OTs are operating theatres, not occupational therapists. HDUs or high dependency units are their term for stepdown units.

In addition to visits to Max Healthcare in Delhi and Fortis Escorts Hospital in Jaipur, speaker Susanne Pavlovich-Danis lectured us on diabetes, DVT, drug seeking behavior and working with people with different personalities.Click to view slideshow.

Other trip highlights included:

• Plane ride to see Mount Everest in Nepal

• Rickshaw ride through the narrow, bustling alleys of Old Delhi

• Visits to Buddhist and Hindu temples and mosques in Nepal, India and the UAE

• Visit to Ranthambore Tiger Reserve where one group saw a tiger

• Bollywood film crew filming at our hotel

• In Dubai, the tallest building in the world

• Visit to a cultural center, where we were served a traditional breakfast of dates, cardamom and saffron coffee, chick peas and pancakes with date syrup

• An evening in the desert including dune bashing (a roller coaster ride in the sand), sunset, camel rides and a traditional meal under the stars

For more information about Gannett study tours.