caring headlines - october 7, 2004 - crossing the culture ... · sengers and prophets beginning...

Inside:Special Diversity IssueSpecial Diversity IssueSpecial Diversity IssueSpecial Diversity IssueSpecial Diversity Issue

Crossing the Culture Chasm ... 11111

Jeanette Ives Erickson ............ 22222Diversity in Health Care

Confronting Disparities ........... 44444

Caring for Non-English-

Speaking Patients ............... 55555

New Bostonians Day............... 66666

Exemplar ................................. 88888Immacula Benjamin, RN

Caring for Children with Multiple

Medical Issues .................... 99999

Food for Thought ................. 1010101010

A Visit to Morocco ................ 1212121212

When in Doubt, Ask ............. 1414141414

Educational Offerings ........... 1515151515

CaringCaringOctober 7, 2004

H E A D L I N E S

WorkingMGH

Prior to blood-pressinformation with visevent. Forty percen

screened

Crossing theculture chasm

PCS Diversity Committee raising awarenessat MGH, in the community, and beyond

ure screening, June McMorrow, RN, sharesitor to the New Bonstonians Community Dayt of the immigrants and refugees who were

tested borderline for hypertension.

(See story on page 6)

together to shape the futurePatient Care Services

October 7, 2004October 7, 2004Jeanette Ives EricksonJeanette Ives Erickson

Jeanette Ives Erickson, RN, MSsenior vice president for Patient

Care and chief nurse

Diversity in health care meansbetter access, better business,

better care for allometimes

change happensdramatically.

Sometimes changehappens subtly, over

time—we find ourselvesin a new culture withouteven noticing the processthat brought us here.When I look around thehospital and see the re-sults of our commitmentto making MGH a wel-coming institution for allour patients and visitors,I can’t believe it’s beenonly seven years sincethe Patient Care ServicesDiversity Steering Com-mittee began its impor-tant work.

This issue of CaringHeadlines, our sixthannual diversity issue, istestament to the successthat the committee andthe MGH communityhave achieved in meetingour original goal to, “leadinitiatives that fosterdiversity of staff andcreate culturally-compe-tent-care strategies that

S support the local andinternational patients weserve.”

We have reason to beproud, but even as wecelebrate our accomplish-ments, we know there isstill much work to bedone. As we continue toaddress challenges suchas eliminating disparitiesin health care, recruitingmore minority profes-sionals, and improvingaccess to care for all pa-tients, we know that aracially and ethnicallydiverse workforce is atthe core of our solutions.Increasing diversity inour workforce improvesaccess and quality ofcare and promotes confi-dence among our minor-ity patients; it attractsstudents of diverse back-grounds; it influences thedirection of our researchand resources; and itimpacts health policy aswe interact with andinform our local, stateand national legislators.

Celebrating RamadanIn the spirit of unity and friendship,

the PCS Diversity Committee, the MGHChaplaincy, and Muslim staff invite you toIftar, the breaking of fast during the Holymonth of Ramadan. All Muslim patients,

family members, staff, and friendsare welcome.

Wednesday, October 27, 20045:15–7:30pm

Wellman Conference Room

For more information, contact Firdosh Pathanat 6-2503, or Lulu Sanchez at 4-0989

At a recent PatientCare Services retreatdedicated to quality,safety, and customerservice, some interestingobservations arose re-lated to diversity and ourcommitment to provid-ing culturally competentcare and retaining a ra-cially and ethnicallydiverse workforce. Ac-cording to a recent studypublished by the Sulli-van Commission on Div-ersity in the HealthcareWorkforce, “diversityand cultural competenceare measurable attributes”of a healthcare system.One measurement toolrecommended by thecommission is a needs-assessment survey. Inappraising the healthcareneeds of a particularcommunity or popula-tion, information on raceand ethnicity can be cap-tured enabling an organ-ization to “approximatetheir workforce needsand ensure a criticalmass of under-represent-ed minority providers.”

At the New YorkTimes, senior vice pres-ident for Human Re-sources, Cynthia Aug-ustine, employs a differ-ent kind of diversity mea-surement tool. She askstwo questions: “Doesyour leadership teaminclude a significantnumber of people fromdiverse backgroundswho are in a position toinfluence the company?”And, “Can people bring

their ‘whole selves’ towork or do they have tocheck their sexual iden-tity, religion, or ethnicityat the door?”

DiversityInc maga-zine recently printed atool for measuring howwell a company’s web-site reflects its commit-ment to diversity. It in-cluded questions like:

Is there a link to diver-sity-related informa-tion on your homepage?Does your websiteinclude multi-culturalimages?Would a search ofyour website using thekeyword, ‘diversity,’yield significant re-sults?Does your websitehighlight activities thatimpact diverse com-munities?Good work is being

done in many venues,and I think it’s time weraise the bar again. It’snot enough to developand implement diversityprograms and initiatives.It’s not enough to incor-porate diversity into our

strategic planning anddecision-making. We needto be able to measure oursuccess and hold ourselvesaccountable for meetingthe goals we’ve set forourselves.

We all understand andappreciate the need fordiversity in health care. Adiverse workforce ensuresa higher level of culturalcompetence, which en-sures a higher level ofquality and safety for allpatients. A diverse work-force brings skilled peo-ple from all backgroundstogether creating a cross-cultural forum for creat-ive thinking. A diverseworkforce contributes tobetter access, better busi-ness, and better care.

I think you’ll find thisissue of Caring Head-lines uplifting and infor-mative.

UpdateI’m pleased to announcethat Coleen Caster, RN,has accepted the positionof nurse manager on theBigelow 7, GynecologyUnit. Coleen will start inher new role on October12, 2004.

October 7, 2004October 7, 2004

Question: I wanted tojoin the Diversity Com-mittee, but I thought itwas only for AfricanAmericans.Answer: The DiversitySteering Committee iscomprised of staff fromall backgrounds. Thereare no ethnic, racial,cultural, or religion-bas-ed prerequisites to join.In fact, membership ofthe committee is not pre-dominantly African Am-erican; it is comprised ofChristians, Jews, Mus-lims, Hispanics, AfricanAmericans, Asians, andpeople of many otherdiverse backgrounds. Weall have one thing incommon. We are commit-ted to supporting anddeveloping strategiesthat transform our worksetting into a more in-clusive and welcomingenvironment for staff andpatients.

Question: What does thecommittee do?Answer: The committeesupports programs andevents that promote theprofessional develop-ment of minority em-ployees, student out-reach, culturally compe-tent care, and patient-education materials spe-cifically designed for adiverse patient popula-tion.

Question: I’ve seen anincrease in the number ofMuslim patients we carefor. But I don’t under-stand a lot about their

religious beliefs. What isthe basis of the Muslimfaith?Answer: The Islamicreligion is misunderstoodby many people. It is, inessence, the message thatGod revealed to His mes-sengers and prophetsbeginning with Adam.Muslims pray to andworship the same God asothers do (Allah is theArabic word for God).Muslims accept and re-spect all the Prophets(Adam, Noah, Abraham,Ishmael, Isaac, Moses,John the Baptist, andJesus, who came beforethe Prophet Mohamed).Muslims believe in theTorah and the Bible.They go once duringtheir lifetime to Mecca, acity in Saudi Arabia, tocomplete a pilgrimagecalled the ‘Hajj.’ This iswhere Kabah is located,the first place of worshipbuilt by the Prophet Ab-raham and his son, Ish-mael, more than 4,000years ago. Islam pre-scribes that Muslimsface in the direction ofthe Kabah when theypray, which symbolizesunity as one communityworshiping One God.

Question: I was surpris-ed when one of my pa-tients told me he wasMuslim, because he did-n’t look Muslim to me.Answer: Not all Mus-lims look alike. Islam isthe second largest reli-gion in the world as wellas in America. There are

more than 1.2 billionMuslims in the worldand more than 8 millionin America. Only 18% ofMuslims live in the Arabworld; 20% in Sub-Sa-haran Africa. Indonesiahas the world’s largestMuslim population. Peo-ple from India, Pakistan,Bangladesh, China, Rus-sia, Europe, and Northand South America areMuslim.

Question: I know thatRamadan is a time offasting and prayer forMuslims. What is themeaning behind thispractice?Answer: Ramadan is theninth month of the Mus-lim calendar. Every yearin the month of Rama-dan, all able Muslimsfast from dawn untilsundown, abstainingfrom food, drink, earthlypleasures and evil inten-tions. Though fasting isbeneficial for health rea-sons, during Ramadan, itis mainly a means ofself-purification andself-restraint. Fastingteaches love, sincerity,and devotion. It developspatience, unselfishness,social conscience and thewill to endure hardship.During Ramadan, Mus-lims focus on their pur-pose in life by constantlybeing aware of the pre-sence of God. Muslims,Christians, and Jewshave much in common.All worship one God,Creator of the Universe.All pledge themselves to

prayer, peace, justice,harmony, cooperation,compassion, charity,family responsibility,and tolerance towardpeople of other faithsand traditions.

Question: A patient toldme he chose MGH be-cause we have a Muslim

prayer room. Is that true?If so, where is it?Answer: The Masjid, orMuslim prayer room, islocated in Founders 109.It is a room where Mus-lim patients and staff cango to pray. The scheduleof prayer times is avail-able in the Masjid.

POPPS Fair 2004Police & Security, Outside Services, andPhotography are proud to announce theirannual Crime Prevention and Safety Fair

ThursdayThursdayThursdayThursdayThursday, October 14, 2004, October 14, 2004, October 14, 2004, October 14, 2004, October 14, 200411:00am–3:00pm11:00am–3:00pm11:00am–3:00pm11:00am–3:00pm11:00am–3:00pm

on the Bulfinch patioon the Bulfinch patioon the Bulfinch patioon the Bulfinch patioon the Bulfinch patio

The focus of this year’s event will be“Protecting You In this Changing World.”

Representatives will be on hand to showcasethe many programs and services available to

the MGH community

The MGH Photography Departmentwill present demonstrations on location

photography, framing, and poster printingand will display entries from the

7th Annual Photo Contest

Staff from the MGH Safety Department,Employee Assistance Program, HAVEN, and

MassGeneral Hospital for Childrenare participating in the fair.

Come enjoy food, fun, free raffles,and educational information from the

department of Police & Security, OutsideServices, and Photography

Questions and AnswersQuestions and AnswersDiversity Committee answers

frequently asked questions

Piecing together the puzzleof domestic violence:

Are you the missing piece?Thursday, October 7, 2004

11:00am–3:00pmUnder the Bulfinch Tent

Remarks by MGH president,Peter L. Slavin, MD, at 12:00pm

For more information contactCorinne Castro, Domestic Violence Events

Committee representative,at 726-8182


uality healthcare and diver-sity intersect

at the bedsideevery day.

Diversity among care-givers and attention toculturally competent careare essential if qualitycare is to be delivered toevery patient. The PCSDiversity Committee hasfocused its efforts oneliminating disparities inhealth care and increas-ing the diversity of ournursing workforce sinceits inception in 1997.

“Improving the healthstatus of the populationby providing nationalleadership in the devel-opment, distribution, andretention of a diverse,culturally competent

health workforce thatprovides the highest qua-lity of care for all,” is themission statement of theDepartment of Healthand Human Services’Health Resources andServices Administrationin the Bureau of HealthProfessions. Their mis-sion mirrors the philoso-phy, beliefs, and pas-sions of the PCS Diver-sity Committee.

The face of Americais changing. By 2050,one in three Americanswill describe themselvesas non-white. Today,Boston, our practice do-main, is described as a‘minority majority’ city.Boston has the fifth larg-est percentage (25.8%)of foreign-born residents

among 23 major metro-politan cities (after Miami,Los Angeles, New York,and Oakland). Nearlyhalf of Boston’s immi-grants entered the UnitedStates in the last decade.

A 1996 survey ofregistered nurses releas-ed by the US Departmentof Health and HumanServices showed thatnearly 90% of the totalnursing population iswhite compared to 72%of the total US popula-tion (who describe them-selves as white). Thislack of diversity is be-coming an increasinglychallenging problem forthe nursing profession.Ideally, the healthcareworkforce mirrors thecultural diversity of its

patient population. Doesthat mean we need to bea certain cultural or eth-nic background to carefor patients? Absolutelynot.

We asked a numberof staff nurses theirthoughts on the subject.They told us that theylearn by listening to theircolleagues. As we shareexperiences, we becomemore aware of how ourpractice can be positive-ly impacted by increasedsensitivity to the culturalneeds and beliefs of ourpatients. Sharing know-ledge and experienceallows us to care effect-ively for patients from awide range of culturesand traditions. In reality,we’re all multi-cultural;some of us may havebeen born in the UnitedStates, others weren’t.

History shows long-standing disparities inthe quality of health careprovided to people ofcolor and other diversebackgrounds. This makesthe need for cultural di-versity among caregiverseven more urgent. Asclinicians we want touncover and dismantlethe processes that contri-bute to disparities incare. Access to qualitycare (or the lack thereof)continues to be the mostimportant predictor ofoutcomes for people ofdiverse racial and ethnicgroups. As an institutionthat trains future caregiv-ers, we have a responsi-bility to educate ourselvesand others about thecustoms, traditions, be-liefs and health practicesof those we serve.

Confronting disparities throughculturally competent care

—by Claribell Amaya, RN; Megan Brown; Kathleen M. Myers, RN;and Ivonny Niles RN

Q

The commitment of theDiversity Committee re-mains strong to create “apractice environment withno barriers that reflects aculturally competent work-force supportive of thepatient-focused values ofthe institution.” If we lookat our nursing employ-ment data over the lastseven years, we see it’sbeginning to reflect ourcommitment to increasingthe diversity of our work-force:

In December of 1997,of 1,782 nurses, 5.5 %were non-CaucasianIn December of 2002,of 2,624 nurses, 6.2%were non-CaucasianIn December of 2003,of 3,085 nurses, 7.0%were non-CaucasianClearly there is an up-

ward trend, and there are anumber of ways we canhelp sustain that forwardmomentum. We can con-tinue to support foreign-born and minority nurses.We can continue to sup-port programs such as theNursing Career LadderInitiative and on-site BSNand MSN programs. Andwe can continue to hire,mentor, and support staff,managers and clinicalspecialists from diversebackgrounds.

An article in the Diver-sity issue of Caring Head-lines in 2001 ended withthe words: “As an institu-tion, our work and dedi-cation (to diversity) arebeginning to show. Thenext time you walk downthe main corridor, lookaround. . . let me knowwhat you think.” We thinkthings are changing. Whatdo you think?

Standing: Claribell Amaya, RN (left); Ivonny Niles RN;and seated: Megan Brown (left); and Kathy Myers, RN

DisparitiesDisparities


hink back toa time when

words like pleur-ocentesis, ECHO

cardiogram, andmetastasis sounded for-eign to us. As providerswe sometimes forgethow and when ‘medicallanguage’ became ourprimary language.

Trying to process andunderstand informationat a time when emotionsare running high andsenses are low is difficultenough for people whospeak English fluently.Imagine being a patientwho speaks no Englishor whose primary lang-uage is not English. Asclinicians we providecare to a culturally di-verse patient populationand we must be compe-tent in every interactionto provide the best pos-

sible care to every singlepatient.

In the past, I’ve hadmany interactions withnon-English-speakingpatients where I wasunable to communicateverbally. I was frustratedwith myself because Iwas unable to have acomplete interactionwith the patient. I canonly imagine how mypatients must have felt asfear ran through theirminds and I couldn’tconsole or explain thecare I was proposing.

As providers we arevery busy and gettingbusier every day. Just asphysical therapists, oc-cupational therapists,and social workers areessential members of thehealthcare team, inter-preters are vital membersof the team for non-Eng-

lish-speaking patients.The obvious benefit ofusing an interpreter isclear, concise communi-cation between providerand patient. Some clini-cians might be wary ofusing an interpreter forfear that the messagecould be ‘mis-interpreted,’and wrongly influencecommunication. Youshould know that medicalinterpreters work withina strict set of standards,one of which is calledjudicious clarification.This means that inter-preters aid the communi-cation process; but it isnot within their scope toexplain a procedure ormedical condition orconvey their own biases.

Many patients holdinterpreters in high re-gard, because they’refrom the same or a simi-lar cultural background.Interpreters can functionas cultural mediators—not by offering opinions,but by providing a moreeffective means of under-standing and communi-cating by applying spe-cific cultural ideals andcustoms to an interac-tion.

To ensure an effectivepatient-provider interac-tion with the help of aninterpreter, providersshould set up a pre-inter-view meeting with theinterpreter. This enablesthe provider and the in-terpreter to review perti-

nent portions of the pa-tient’s medical history.During the interactionwith the patient, provid-ers should speak directlyto the patient (not theinterpreter) and use non-verbal as well as verbalcues to communicate.This enables the providerto ‘read’ the patient’sfacial expressions andnon-verbal cues.

The same challengesthat impact the care ofnon-English-speakingpatients in the hospitalsetting affect ambulatoryand home-care patientsas well. I once received acall from a private nursewho was caring for aChinese-speaking patient(who was under my care)in his home. The patienthad undergone an exten-sive surgical procedureand needed to be eval-uated on a continuingbasis. The nurse wasunable to communicatewith him, which madecaring for him effectivelynearly impossible. Thisis a perfect example of asituation where an inter-preter’s services in ahome-care setting would

Overcoming challengesin caring for non-English

speaking patients—by Tamara K. Edelman, NP

have been invaluable.Being aware of thesechallenges can help leadto viable solutions andimproved care for allpatients.

Non-English-speak-ing patients, like Eng-lish-speaking patients,can usually repeat backonly 30% of verbal in-structions or informationduring a visit. So it’simportant that verbalinformation be short andconcise. It may take morethan one attempt for apatient to fully compre-hend something. Be pa-tient, confident, and in-ventive with your com-munication. If possible,provide written informa-tion in the patient’s pri-mary language, use pic-tures, and include thepatient’s family in theplan for care at home.

It’s important to re-member as we strive toexcel as caregivers, thatthe most effective formof communication is stilla smile and the touch ofa hand. And that’s thesame in every language...even medical.

Tamara K. Edelman, NP,nurse practitioner

T

Interpreter ServicesInterpreter Services

Domestic ViolenceSupport Group

The Employee Assistance Program isoffering a 10-week support group for female

employees who have been affectedby domestic violence in a past or

current relationship.

The group is free and confidential

The first meeting will be heldThursday, October 14, 2004

4:30–6:00pm

For more information, contact Donna at theEAP: 726-6976 or 1-866-724-4EAP

n-

st’sn,

ea-n-

se


MGH employeeswelcome ‘New Bostonians’ in

special multi-cultural event—by June McMorrow, RN; and Elizabeth A. Nolan, MALD

n an effort to ad-dress healthcaredisparities amonglocal linguistic mi-

norities, the PatientCare Services DiversityCommittee joined forceswith Interpreters Services,Human Resources, the Part-ners International Program,and the Mayor’s Office ofNew Bostonians to conduct

free blood-pressure screen-ings and distribute ‘basicmedical ID cards’ duringBoston’s fifth annual NewBostonians CommunityDay Celebration. The eventtook place September 22,2004, at City Hall Plaza.

Approximately 150 ref-ugees and immigrants vis-ited the booth, where theywere greeted by nurses and

bi-lingual volunteers, whohelped them fill out wallet-sized cards containing im-portant health informationsuch as their name, nativelanguage, blood pressure,known allergies, and emer-gency contact information.In addition to laminatedmedical cards, the teamdistributed multi-lingualinformation on asthma,

diabetes, and high bloodpressure.

June McMorrow, RN,who volunteered to staff thebooth for the second year ina row, says, “Participatingin this event gives me anopportunity to share myenthusiasm for nursing byinteracting with peoplefrom many different groupswithin the city.”

Nearly 4,000 peopleattended the 2004 NewBostonians CommunityDay celebration. Visitors tothe MGH booth hailed fromBosnia, Burma, Brazil,China, Cape Verde, Colom-

bia, the Dominican Re-public, Greece, Haiti, Keya, Panama, Peru, PuertoRico, Somalia and Viet-nam.

According to the latecensus, 25.8% of Bostonresidents are foreign-borand more than 140 lang-uages are spoken in ourcity. Twenty percent ofBoston’s schoolchildrenspeak a language otherthan English at home, thmost prevalent being Spnish, Haitian Kreyol, Madarin, Portuguese, CapeVerdean Kriol, Vietnameand French.

Community OutreachCommunity Outreach

I

Above and on opposite page, members of the PCS Diversity Committee and hospital volunteers participate in this year’s New Bostonians Community Day eventat City Hall Plaza, providing free blood-pressure screenings and medical ID cards to refugees and immigrants new to the Boston area.

jeb23

Continued on Next Page


Locally, more immi-grants work in the healthand social-services fieldthan in any other sector.Because access to employ-ment opportunities wasidentified as a key needamong newcomers, thisyear, MGH added bi-ling-ual employment informa-tion to the materials theydistributed at the event.

Commenting on thevalue of Boston’s multi-culturalism, director of PCSDiversity, Deb Washington,RN, said, “Every time anew patient or staff memberwalks through our doors,MGH is re-born. If youlook back at our history, ourstrength and innovationhave always been derivedfrom diversity—diversity

of people, diversity of ideas,diversity of experiences.”

New Bostonians Com-munity Day was establishedin 1999 as the city’s mostvisible celebration of im-migrants and multi-cult-uralism. Coordinated by apublic/private coalitionrepresenting various citydepartments and commu-nity organizations, New

Bostonians CommunityDay helps facilitate the in-tegration of newcomers intoour society by explaininghow city government worksand by highlighting manyavailable social services.

Activities include freeimmigration clinics, per-formances by musiciansand dancers, multi-lingualtours of City Hall, and an

information fair consistingof resource tables on topicssuch as health, housing,employment, civil rights,youth activities and educa-tional opportunities.

For more informationabout the New BostoniansCommunity Day event,contact Beth Nolan of theMGH International Pro-gram, at 726-4284

October 7, 2004October 7, 2004ExemplarExemplar

Immacula “Ki-Ki” Benjamin, RN,staff nurse, Ellison 18

MHealing through patience

and understandingy name is Im-macula Benja-min. I am theresource nurse

on the Ellison18 Adolescent PediatricUnit. I have worked atMGH for 27 years, andthe patient I’m going totell you about has chal-lenged all my skills, ener-gies, compassion, andcreativity.

‘Angelica’ is a 14-year-old Haitian girl whomI first met a few monthsago when she was ad-mitted to our unit withencephalitis. I becameher primary nurse. I knewwhen I saw her and learn-ed her history that shewas going to need some-one to look out for her, toprotect her, to go theextra mile in getting herwhat she needed. I enter-ed the relationship withmy eyes wide open as Ihave cared for ‘difficult’patients before.

Angelica was in DSScustody due to allega-tions of abuse in heraunt’s home where shelived. Angelica had cometo America from Haitiwith her aunt a few yearsbefore. She left not onlyher mother, but also hercountry and the nativeculture she was so ac-customed to, which in-cluded the frequent prac-tice of her religion. Hersister also lives here withher aunt. Angelica’s auntcontinues to be involvedwith her, and DSS hasappointed a guardianwho is attentive to An-

gelica’s needs. Her sisteracts as a link betweenAngelica and her motherin Haiti.

Angelica’s medicalcourse has been veryrocky, requiring the bestskills of many of ourservices. As her primarynurse it has been up tome to coordinate theseservices, provide directcare, and keep Angelicasafe from herself. Alongwith a host of medicalcomplications some re-quiring a stay in the Pe-diatric Intensive CareUnit, Angelica’s beha-vior has been one of themost difficult challengesin her care. She has ex-treme obsessive-compul-sive behaviors, aggres-sive tendencies, and adesire to flee at any op-portunity.

My primary concernupon assessing Angelicawas her safety. At times,her behavior required herto have sitters and/or softrestraints. At one pointshe was moved to a VailBed (a bed totally en-closed with a zipper soshe could move freelybut not flee).

One of my first chal-lenges was to educatestaff about why the bedwas necessary and howit worked. One day, anenergetic medical studentwent into Angelica’sroom to do an exam andas soon as he opened thezipper she was out ofbed and down the hall.This brought everyone tothe hallway to help. I

know there’s somethingto be said for exercise,but I cringed when Ithought about how fright-ened she must have beenas we tried to ‘catch’ herand get her back to bed.

How to coordinatethe efforts of all the ser-vices became my nextchallenge and highestpriority. I felt if I couldget everyone in the sameroom, I could provide aclear understanding ofAngelica’s special needs.I called a team meetingand invited all membersof her care team (Speech-Language Pathology,Occupational Therapy,Physical Therapy, Diet-ary, Child Life, Chaplain-cy, Psychology, DSS, herphysician and others). Itwas very heartwarmingto see the turn-out. I couldsee how much they allcared and wanted thebest for Angelica. Every-one was willing to listenand learn and work to-gether.

All services reportedon their interactions withAngelica, and the com-mon thread from every-one was this young girl’sspiritual connection andher love of the religiousrituals from her home-land (Haiti). We werefortunate to have a chap-lain present from Haitiwho was able to con-verse and pray with An-gelica in her own lang-uage. Prayer helped tocalm her like nothingelse had. My job as pri-mary nurse at this meet-

ing was to connect thedots and see how wecould use Angelica’sculture and religion tohelp her heal and makeher time with us lesstraumatic.

In the following weekswe worked on a plan inwhich prayer was a bigpart of her daily routineand therapy. Chaplainsweren’t the only ones topray with her, but theybecame the most visibleand important part of hercare plan and team.

Angelica’s mothersent her a dress fromHaiti, with instructionsfor us on when to put iton her (a particular timeand date). The dress camewith a prayer card, whichwas to go under her pil-low. I made sure this wasdone, and it was amazingthe effect it had on An-gelica. She became socalm and cooperativewith prayer.

Every departmentindividualized the carethey provided for Angel-ica, celebrating her di-versity to help her heal.Nutrition & Food Ser-vices made special meals

for her. OT and PT work-ed with child life special-ists to incorporate theirtherapies into specialactivities and times forher. Nurses took the timeto learn her special dailyneeds, and that, in itself,made her care easier.

Angelica remains atMGH as we look for theproper discharge plan forher, one that can keepher close to her family inAmerica and support herethnic diversity and reli-gious practices. We don’tknow how Angelica willprogress medically, onlytime can answer that.

What Angelica hastaught me is invaluable:patience, that nothinghappens quickly; faith ina supreme being and thehealing peace that beliefcan bring; and the impor-tance of primary nursing.Nurses make a differ-ence. I know I’ve made adifference in Angelica’slife. Pediatric nurses arethere to pull all the won-derful people together toprovide the best carepossible for our youngpatients.


Caring for children withmultiple medical issues

—by Carly Jean-Francois, RN, staff nurse, Ellison 18

Carly Jean-Francois, RN,Staff nurse, Ellison 18

he Diversityissue of Caring

Headlines maynot seem like a

place where you’dread about children withmultiple medical issues.But children who sufferfrom a variety of physi-cal and developmentalchallenges are often re-garded as ‘different’ or‘outside the norm.’ Per-haps physician, JeffreyBosco, from the Univer-sity of Miami phrased itbest when he said, “Thereis something about theirbody that makes themdifferent from most otherpeople. Maybe their eyesdon’t see or their earsdon’t hear. Maybe theirlegs don’t move throughspace or their brain does-n’t get through a book.After that, it’s all thesame. These childrenshare some of the samestruggles, longings, fears,joys and pains as anyoneelse.” When consideredthrough this quote andthe stories of the familieswe see, these childrenand their families facemany of the same issuesas people of color andpeople from diverse eth-nic backgrounds.

We live in a worldwhere we label peoplewho are different fromus. Terms such as handi-capped, mentally differ-ent, slow, development-ally delayed, special, andphysically-challengedare used to describe these

individuals. Sometimes,in an effort to improvetheir prognoses, childrenare placed in homogen-ous groups where theirdiverse cultures becomelost. The holistic andadvocacy needs of thesechildren and families aregreat, and the need forindividualized services issteadily rising. This is anopportunity for nursingto intervene and make asignificant difference.

Recent surveys con-ducted by the Center forDisease Control andPrevention reported thatapproximately 13% ofall children have specialhealthcare needs reflect-ing a wide range of se-verity. Findings from thisstudy revealed that thesechildren have an ongoingneed for health services,yet 21% of respondentsreported difficulty insecuring referrals forthose specialized healthservices. Parents becomefrustrated that there arecenters and clinics devot-ed to their child’s limita-tions, but few that lookat the needs of the childand family as a whole orthat focus on their abili-ties rather than their dis-abilities.

Every day as medicalprofessionals we share inthe experience of fami-lies receiving news of a‘not-so-perfect baby.’ Weshare health informationthat profoundly affectsthe lives of an entire

family, yet for many ofus it’s just our job andwe move on. Mrs. Wood,a member of the Mass-General Hospital forChildren Family AdvisoryCouncil shared some ofher thoughts regardingher child, Nancy, andtheir family’s journey inthe healthcare system.When the Woods learnedthat Nancy was bornwith a chronic medicalcondition, they weredevastated. They feltangry, afraid, helpless,and vulnerable. Theydidn’t know if they werecapable of caring forNancy at home. Theynever doubted their lovefor Nancy but fearedmaking the wrong deci-sions about her care. TheWoods wanted a pedia-trician whom they couldpartner with, who wouldvalue Nancy’s life andsee her potential as theydid. They wanted some-one who would listen totheir hopes for Nancyand treat her symptomsnot her diagnosis.

The Woods connect-ed with MassGeneralHospital for Children’sDr. Robert Wharton.Says Mrs. Wood, “Hewas the first doctor wemet who was braveenough to give us hopefor the future.” Recentresearch suggests thatwhen parents are given arealistic image of theirchild’s disability andwhen they receive ade-

quate information andpractical advice on howto care for their child ineveryday life, it can havea positive effect on thefunctioning of the familyas a whole. The Woodsare a perfect example ofthis.

The partnership thatformed from their firstconversations with Dr.Wharton has taught theWoods and parents likethem the importance ofvaluing all children asindividuals. When itcame to Nancy’s careand well-being, Dr. Whar-ton was more than herpediatrician. His know-ledge and expertise aboutNancy’s condition allow-ed the Woods to becomebetter caregivers, teach-ers, therapists, advocates,nurses, and most of all,parents. He made homevisits and took a genuineinterest in Nancy’s tri-umphs. Mrs. Wood ac-knowledges the gift theyhave in Dr. Wharton, asit’s not always easy tofind medical profession-als willing and able totake on a child and fam-ily with special needs. It

can be frustrating forboth medical profession-als and families, anddevastating for a family,when their child is ‘re-fused’ by a healthcareprofessional. Unfortun-ately, our healthcare sys-tem doesn’t always sup-port or reimburse thekind of care these child-ren and families need.Physicians sometimesfeel that their practicecan’t handle the increas-ed workload and thesystem doesn’t allowreimbursement for theextra time necessary toprovide coordination ofcare. However, parentscan be our greatest ally ifthey are valued for theexpertise they provide astheir child’s primarycaregiver. Nurses andnurse practitioners canuse their role as advocateand coordinators of careto work with families todevelop and support aplan of care that is fam-ily-centered, coordinatedwithin the community,supportive of the child’sstrengths, and proactivein helping the child at-

continued on page 16

T


Food for thoughttapping into the cultural richness of

Nutrition & Food Services—by Mary Cunningham, and Judy Newell, RN

very member of thehealth team has aunique life experi-ence that adds spe-

cial meaning and perspec-tive to his/her work. In thedepartment of Nutrition &Food Services, more than140 cultures are represented,bringing a multi-ethnic arrayof beliefs, customs, and tra-ditions to MGH. Among themany wonderful differencesderived from diverse cul-tures is our relationship to,our preparation of, and ourappreciation for, food!

Recently, a group of nu-trition service coordinatorsand dietitians from Nutrition& Food Services came to-gether to share some of their

thoughts on the meaning andsignificance of food in theirnative countries (India, Ja-maica, Monserrat, Morocco,Puerto Rico, Barbados, andthe United States). How domembers of this diverse de-partment feel about food asthey plan and coordinate thedelivery of more than 2,500meals to our patients everyday?

One observation thatcame out in the course of thediscussion was how the ab-undance or scarcity of food inone’s homeland can influencethe value that is placed onfood in this country. The im-portance of choice was ano-ther factor in how peopleperceived food—in most

areas of the United States,there’s a wide variety offoods to choose from. Inother countries, choice canbe non-existent. In somecultures food is a sign ofacceptance, hospitality orgood cheer. When not eaten,it may be interpreted as asign of waste, carelessnessor insult.

As we listen to thesecomments, recollections, andobservations about the sig-nificance of food in variouscultures, we are moved tothink about the importanceof food in the lives and careof our patients who come tous from all over the world.What is their relationshipwith food...?

E

Sarah Estabrook, RDassistant manager, Patient Food Services

“I come from a wonderful New Englandbackground of baked beans and brown bread. I reallyenjoy interacting with the diverse population at MGHand having the opportunity to create different foods

for our patients from all over the world.”

Simone Prescod

“My mother lives in this country now. When shespends holidays with friends, she doesn’t eat anythingbecause she knows that relatives back home have no

food. When I see all the food that goes to waste,it hurts my heart; I know so many people

who have so little.”

Tiash Sinha

“We are so concerned that our patients receiveproper nutrition, that we often order more for themthan they can eat. In many cultures, this is seen as

wasteful. It is upsetting to some people.”

Maudline Tuitt

“I work at Coffee Central, and I see how food‘connects’ people every day. After I take someone’sorder a few times, I always remember what they like.When I see them again, I know what to get for them.”

Francisca Nogbou

“My job is to mix up food in a blender for patients whohave special diets. Sitting in my work area all day, it’s

easy to forget why I’m doing what I’m doing. But when Igo up to the units and see all the patients, I am

reminded why my work is so important. When I stopseeing a certain recipe, I always wonder if that

patient has been discharged.”

Culture and CuisineCulture and Cuisine

jeb23

Continued on Next Page


CaseManagement Week

Case Managers, the passion for caring,the power of collaboration, the promise

of hope

Visit the Case Managementinformation booth

October 12 and 14, 20048:00am–4:00pmMain Corridor

Attend educational session on,“Alternative Therapies” that will combine

information about complementaryand alternative therapies

November 2, 20042:00–3:00pm

O’Keeffe Auditorium

(CEUs and CCMs TBA)

The annual Case ManagementVariety/Change Show

October 14, 20043:00pm

Meltzer Auditorium, MEEI3rd floor

All are welcomeFor more information, contact Anna Carsonat 6-8184, or Melissa Robinson at 4-7474

The Patient Education Committeepresents:

Healthy Behaviors:Coaching your Patient

to SuccessFeaturing keynote speaker, James

Prochaska, PhD, author of Changing forGood and The Transtheoretical Approach

Professionals in the fields ofaddiction, decision-making, weight-control,

smoking-cessation, and exercise willreport on their experiences

Come learn how people makedecisions to change

November 5, 20048:00am–4:30pm

O’Keeffe Auditorium

7.5 Contact HoursPre-registration is required. For more

information, call the Center for Clinical &Professional Development at 726-3111

Nancy Medina

“I remember thinking that Americanfood was so bland. In my country, we haveso many distinctive spices. We use spice

on everything!”

Chhaya Sithowath

“I learned to cook in the army in my country. Thingswere a little different there. If you didn’t do somethingright, you could get shot! I worked very hard to learn

how to cook, and I’m proud of the work that I do.”

Miriam McLean

“I come from the beautiful isle of Jamaicawhere everything is wonderful, and food is a big partof our culture. It is amazing the effect your physicalsurroundings can have on your mood and spirit.”

Ghislaine Laurore

“When I first came to this country, it took mea while to get used to the food—everything looksand tastes so different here. I really missed the

familiar foods of home. I’m starting to getused to American food. A little bit.”

Mustapha El Fakir

“In my country, freshness is everything.No one uses freezers. Ingredients go straight fromthe garden to the table. In this country, food can sit

in a freezer for months at a time.”

Gertrude Dominique

“Here at MGH, our patients are givena choice as to what they want to eat. In the hospital

back home, there is no choice. Patients getwhatever is available. Sometimes chicken

broth is all there is.”


y odyssey beganwhen Touria, afriend at MGH,invited me to go

home to Mor-occo with her. I was boththrilled and apprehensiveabout this opportunity tovisit a country whosename evoked a sense ofmystery and intrigue.

Morocco is in NorthAfrica where the lang-uage and culture are verydifferent. Not knowingmuch about the area, Ihave to admit, I wonder-ed about safety, the poli-tical climate of the coun-try, how women weretreated, and a number ofother fleeting concerns.But I soon realized thatwhat I feared was theunknown. I remindedmyself that I trusted myfriend and knew she’dnever put me in harm’sway. I accepted Touria’sinvitation, then went outand bought a travel guideto educate myself andprepare for my journey.

Any doubts about mysafety were quickly dis-pelled as I landed at Mo-hammed V Airport. Tou-ria’s family greeted mewarmly, and I felt safeand well cared for duringmy entire visit.

Great excitementsurrounded our arrival.Sisters, brothers, moth-ers, cousins, aunts, uncles,nieces and nephews hadmade the three-hour tripto Casablanca to meetTouria and her husband

who were returning toMorocco for the firsttime in two years. Tearsof joy were shed as theywere reunited with theirtwo-year-old son (wholives in Morocco be-cause of the expense ofchild care in America).Family members greetedme using whatever Frenchor English they knew tomake me feel welcome.We piled into four carsand a small truck alongwith six, 70-pound suit-cases brimming withgifts from America.

Touria’s family haslived in the same neigh-borhood for many years.Recently they movedinto a new house, builtwith money earned work-ing many over-time hoursin America. Touria’sfamily lives upstairs; herhusband’s family liveson the first floor. Thedoors to both apartmentsare always open andfamily members driftcomfortably between thetwo homes. Because ofour visit, relatives camefrom far and near. WhenI woke up each morning,I never knew how manyrelatives would be there.The lilt of female voiceschattering, all wanting totalk to their long-absentrelatives could be heardthroughout the home. Ididn’t understand a wordof Arabic, but the happi-ness in that chorus ofvoices told me that therewas a lot of joy and lovepresent.

Meal time was a won-derful, community event.All the women seemed tohave a part in preparingand serving the food.Each meal began withrituals acknowledgingthe respect and valuesthat bonded this large,extended family. Tea, thetraditional Moroccandrink was a staple ateach meal. One of thewomen would bring atray with glasses and atea pot. The tea was pour-ed in a formal ritual withthe pot held high overthe glass, the sweet li-quid cascading downfrom the spout. Beforeeating, someone wouldbring around a kettle ofwater and a bowl for usto wash our hands. Alarge platter of food wasplaced in the middle ofthe table; everyone help-ed themselves, usingpieces of bread to scoopup savory meats andfresh vegetables. Thefood was so flavorful,subtly infused with won-derful spices like cinna-mon, paprika, cardamomand saphron. There wasalways plenty to eat nomatter how many peoplecame to the table. Laugh-ter and camaraderie wereever present, and I alwaysfelt part of the group. Wequickly learned to com-municate with a fewwords, gestures and fa-cial expressions.

Communication wasa great source of enter-tainment between the

children and me. Theywere very curious aboutme and often tried toengage me in some way.We would play wordgames to try to learn eachother’s language. ‘Thank-you’ was the one wordeveryone seemed to under-stand. Yassim, Touria’s12-year-old nephew madea special effort to tell me,“I hope to travel in Amer-ica.” I was honored thathe made such an effort tofind words to speak withme in English—thatmemory is my favoritesouvenir of Morocco.

Children ranged inage from two to 20. Theywere polite and friendly.They seemed to be hap-py and secure in theirextended family. Therewas some rivalry amongthe younger children buteveryone looked afterone another. Comingfrom a home where myfour-year-old grandsonhas more toys than heknows what to do with, Iwas very impressed athow few toys it took toentertain these children.They were so creative atmaking up games with

simple things like paperairplanes and make-shiftjump ropes.

Marriage customswere very interesting.The reasons for gettingmarried seemed to varywith the age of the girl.Touria’s older sisters’marriages were arrangedby their father. Theywere married in theirearly teens because theirfather thought it was bestfor women to have child-ren while they were young.Touria’s oldest sister hadher first baby when shewas 14. She is now agrandmother at the ageof 44. A couple of sib-lings in their 20s workprofessionally and havenot yet married. Theyplan to marry in the fu-ture because they wantchildren and companion-ship as they grow older.Touria is the baby of herfamily. She was 26 whenshe married. She and herhusband chose to marrywhen he won a lotterythat allowed him to cometo America with a wife.None of the typicallyromantic notions that

A visit to Morocco:the journey of a lifetime

—by Beverley Cunningham

Touria Ghoubache (left) andBeverley Cunningham

M

continued on next page

Cultural ExchangeCultural Exchange

October 7, 2004

October 7, 2004

Next Publication Date:December 18, 2004

Published by:Caring Headlines is published twice eachmonth by the department of Patient Care

Services at Massachusetts General Hospital.

PublisherJeanette Ives Erickson RN, MS,

senior vice president for Patient Careand chief nurse

Managing EditorSusan Sabia

Editorial Advisory BoardChaplaincy

Reverend Priscilla Denham

Development & Public Affairs LiaisonVictoria Brady

Editorial SupportMarianne Ditomassi, RN, MSN, MBAMary Ellin Smith, RN, MS

Materials ManagementEdward Raeke

Nutrition & Food ServicesMartha Lynch, MS, RD, CNSD

Office of Patient AdvocacySally Millar, RN, MBA

Orthotics & ProstheticsMark Tlumacki

Patient Care Services, DiversityDeborah Washington, RN, MSN

Physical TherapyOccupational Therapy

Michael G. Sullivan, PT, MBA

Police & SecurityJoe Crowley

Reading Language DisordersCarolyn Horn, MEd

Respiratory CareEd Burns, RRT

Social ServicesEllen Forman, LICSW

Speech-Language PathologyCarmen Vega-Barachowitz, MS, SLP

Volunteer, Medical Interpreter, Ambassadorand LVC Retail Services

Pat Rowell

DistributionPlease contact Ursula Hoehl at 726-9057 for

all issues related to distribution

Submission of ArticlesWritten contributions should be

submitted directly to Susan Sabiaas far in advance as possible.

Caring Headlines cannot guarantee theinclusion of any article.

Articles/ideas should be submittedin writing by fax: 617-726-8594or e-mail: [email protected]

For more information, call: 617-724-1746.

Please recycle

motivate courtship and marriagein our country influenced theirdecision to wed. They became acouple because their familieshad known each other as neigh-bors. They knew they shared thesame values and goals and theyrespected each other. They arecommitted to each other andboth work very hard to supporttheir son and families who re-main in Morocco. The marriedchildren of Touria’s family con-tinue to maintain strong bondswith their maternal relatives andinvolve them in the raising oftheir children.

On my last morning in Mor-occo I was awakened at 4:00amby the call to prayer that re-sounds from every minaret ofevery mosque throughout thecountry. As I lay quietly waitingfor the family to stir, I heard asymphony of sounds: dogs bark-ing, roosters crowing, donkeysbraying, cars passing on thestreet below. The chorus waspunctuated by the rhythmicclip-clopping of horses pullingflat-bed carts to market. Thispre-dawn serenade was a re-minder that this country had not

yet caught up with the fast-pacedhustle-bustle of the twenty-firstcentury. I found a kind of com-fort in realizing that people canlive without fast cars, fast foods,super markets and shoppingmalls. Perhaps it’s the slowerpace that allows people to appre-ciate the value of their traditionsand families, and the sense ofcommunity that comes fromworking and living together andsharing limited resources.

At the airport as I preparedfor my flight home, I got a senseof how Touria and her husbandmust have felt when they firstarrived in America speakingvery little English. I was fright-ened because I realized therewas little I could do to commu-nicate with the people I neededto interact with. For that shortamount of time, I felt very vul-nerable. I can only imagine feel-ing that way every day whileattempting to find work or car-ing for a family. I have develop-ed great respect for those whorisk feeling alone, isolated, andhelpless in order to make a bet-ter life for themselves and theirfamilies.

I could go on and on aboutthe fascinating things I learnedin Morocco. It was an incredi-bly rich experience despite thefact that few words were ex-changed. I discovered that thepeople of this North Africannation love their god and areproud of their history. They loveto shop, eat sweets, go to thebeach, and have coffee withfriends. They love their familiesand are true to their friends.

I also learned somethingabout myself. I realized that thethings I take for granted (airconditioning, owning my owncar, being educated in my pri-mary language, receiving healthcare from knowledgeable andcaring clinicians) are rare privi-leges for others. I found howmuch can be communicated andunderstood without words. Ifound that how a message iscommunicated can be more im-portant than the words that arespoken. And most importantly, Icame to understand that youhave to suspend judgment andpreconceptions and learn byexperiencing. The results are sorewarding.

Touria (front left) with herfamily in Morocco


ven under thebest of circum-stances, visiting a

hospital for carecan be an intimi-

dating experience. Weoften put these visits offfor as long as possible toavoid the anxiety theyinspire. For millions ofAmericans who havelimiting disabilities, avisit to the hospital iseven more daunting.

We all have questionswhen we arrive at a hos-pital for the first time.How do I get where Ineed to go? Where do Iregister? What kind offorms will I need to fillout? How long will Ihave to wait? How muchtime will I spend withthe clinician? Add a vis-ual, hearing, mobility, or

cognitive impairment tothe mix, and fear andanxiety increase expo-nentially.

Just getting to anappointment can be liketackling an obstaclecourse. Transportationcan be an issue. The phy-sical layout of the build-ing can present a numberof challenges. Wheel-chair access may not beavailable in all areas.Signage for blind andvisually impaired pa-tients may not exist. As-sistance may be neededto fill out forms. Whattakes a ‘normally’ func-tioning person a fewseconds could take aperson with disabilitiesmuch longer; and there isan added level of frustra-

tion that accompaniesthese barriers.

Recently, the Councilon Disabilities Aware-ness sponsored a paneldiscussion where indivi-duals with disabilitieswere invited to talk withMGH employees abouthow their disabilitiesaffect their day-to-dayactivities. Much of whatwas said enlightenedaudience members andbrought a new perspec-tive to the table.

Here are a few of thecomments:

“As a blind person Ifind it difficult to navi-gate unfamiliar, openspaces (such as lobbies)without support.

I prefer to have regi-stration information sent

to me in ad-vance so I cancomplete it inprivacy in-stead of hav-ing someoneassist me in awaiting roomwhere otherscan hear myresponses.”

“I’m notdeaf, but I amhearing-im-paired, so Iread lips. Ican’t read lipswhen peoplecover theirmouths whenthey speak. Inthe waitingroom whenthe reception-ist calls a

patient’s name frombehind a clipboard, Ican’t tell who she’s call-ing. If no one gets up, Iassume it must be me.”

“ As a wheelchair user Ifind many obstacles thatimpede my access toservices. Public transpor-tation is one of the worst.To get here today, I hadto get off two stops away(because the MGH T-station is not equipped tohandle wheelchairs) andpropel myself throughfour city blocks overcobblestones and bricks.I’m glad I was able to gethere, but I knew full wellthat when I got to thedoctor’s office it wouldbe an ordeal to transferfrom my chair to theexam table.”

“My anxiety disordercan make it difficult forme to focus, and I’measily distracted in busyplaces. So I try to avoidthem.”

These examples give ussome insight into why aperson with a disabilitymight delay seeking med-ical help. Regardless ofwhy an appointment was

When in doubt, ask...—by Oswald Mondejar, Human Resources manager

and disabilities coordinator

Oswald Mondejar,Human Resources manager

E

made, often the disabilitybecomes the focus in themind of the clinician,and this can be an un-welcome distraction.

Individuals with dis-abilities ask that you seeus as whole people withdifferent ways of achiev-ing similar objectives.Clearly, the world wasnot designed to accom-modate the vast array ofabilities shared by thispopulation; so we adjustand plan ahead in orderto participate fully in theeveryday aspects of life.It’s a responsibility thatcomes with the territory.When help is neededwe’re the first to know. Ifyou think a person witha disability may needhelp, don’t hesitate tooffer assistance. Ulti-mately, we just ask thatyou see us as people.

I recently visited oneof our clinics and whenthe exam was completedthe nurse asked, “Can Iassist you with buttoningyour shirt?” Though Ididn’t need help, theoffer was appreciated.

The best advice is...“When in doubt, ask.”

Panelist at the Council on Disabilitiesforum shares his experiences as a

person with disabilities navigating thehealthcare system

Raising AwarenessRaising Awareness

Educational OfferingsEducational Offerings October 7, 2004October 7, 2004

2004

2004

For detailed information about educational offerings, visit our web calendar at http://pcs.mgh.harvard.edu. To register, call (617)726-3111.For information about Risk Management Foundation programs, check the Internet at http://www.hrm.harvard.edu.

Contact HoursDescriptionWhen/WhereA Diabetic OdysseyO’Keeffe Auditorium

TBAOctober 188:00am–4:30pm

USA Educational SeriesBigelow 4 Amphitheater

- - -October 201:30–2:30pm

BLS Certification for Healthcare ProvidersVBK601

- - -October 218:00am–2:00pm

Building Relationships in the Diverse Hospital Community:Understanding Our Patients, Ourselves, and Each OtherTraining Department, Charles River Plaza

7.2October 218:00am–4:30pm

Congenital Heart DiseaseBurr 3 Conference Room

4.5October 227:30–11:30am and 12:30–4:30pm

CPR—American Heart Association BLS Re-CertificationVBK 401

- - -October 257:30–11:00am/12:00–3:30pm

Intra-Aortic Balloon Pump WorkshopDay 1: Wellman Conference Room. Day 2: VBK601

14.4for completing both days

October 25 and 267:30am–4:30pm

CPR—Age-Specific Mannequin Demonstration of BLS SkillsVBK 401 (No BLS card given)

- - -October 268:00am and 12:00pm (Adult)10:00am and 2:00pm (Pediatric)

New Graduate Nurse Development Seminar IITraining Department, Charles River Plaza

5.4 (for mentors only)October 278:00am–2:30pm

Nursing Grand Rounds“Focus on Patient Safety.” O’Keeffe Auditorium

1.2October 281:30–2:30pm

Workforce Dynamics: Skills for SuccessTraining Department, Charles River Plaza

TBAOctober 298:00am–4:30pm

Basic Respiratory CareEllison 19 Conference Room (1919)

- - -October 2912:00–3:30pm

BLS Certification–HeartsaverVBK 601

- - -November 28:00am–12:00pm

Greater Boston ICU Consortium CORE ProgramDays 1, 2, 3, 6 Wellman Conference Room. Days 4, 5, O’Keeffe Auditorium

44.8for completing all six days

November 3, 4, 8, 12, 15, 197:30am–4:30pm

Natural Medicines: Helpful or Harmful? Researching theLiterature on Herbs and Dietary SupplementsFounders 626

1.8November 34:00–5:30pm

CPR—American Heart Association BLS Re-CertificationVBK 401

- - -November 47:30–11:00am/12:00–3:30pm

Healthy Behaviors: Coaching Your Patient to SuccessO’Keeffe Auditorium

- - -November 58:00am–4:00pm

16.8for completing both days

Advanced Cardiac Life Support (ACLS)—Provider CourseDay 1: O’Keeffe Auditorium. Day 2: Wellman Conference Room

November 8, 128:00am–5:00pm

Congenital Heart DiseaseBurr 5 Conference Room

4.5November 87:00–11:am and 12:00–4:00pm

New Graduate Nurse Development Seminar ITraining Department, Charles River Plaza

6.0(for mentors only)

November 108:00am–2:30pm

OA/PCA/USA Connections“Personal Safety: Services Offered by Police & Security.” Bigelow 4Amphitheater

- - -November 101:30–2:30pm


CaringCaringH E A D L I N E S

Send returns only to Bigelow 10Nursing Office, MGH

55 Fruit StreetBoston, MA 02114-2696

First ClassUS Postage PaidPermit #57416

Boston MA

tain his/her fullest po-tential.

At the MassGeneralHospital for Children,we are ever aware of theneeds of this populationof children and families.Advances in medicaltechnology and medicalresearch have improvedsurvival rates of childrenwith a wide range ofdiagnoses. Nursing re-search demonstrates thatwith a family-centeredapproach to care, thechild and family can beempowered to navigatethe healthcare systemand function effectivelyin the community.

Family-centered carerecognizes the centralrole that parents, sib-lings, and significantothers play in the lives ofchildren. It supports al-liances where familiesand professionals work

collaboratively, eachbringing different know-ledge and skills to therelationship. It’s impor-tant to recognize thevalue of parents as inte-gral members of the careteam. It’s equally impor-tant to help them copewith the stresses of par-enting a child with mul-tiple medical challenges.As part of our mission atMassGeneral Hospitalfor Children, we are ded-icated to serving the pedi-atric community andrealize that excellence incare is the result of aninterdisciplinary effortrequiring collaborationfrom all members of thecare team. We advanceour understanding ofillness through innova-tive medical research andeducation, we are empow-ered by skill and techno-logy, and we are motivat-

ed by a commitment toexcellence in pediatricpractice that is sincereand compassionate. (MassGeneral Hospital forChildren 2002).

Different is beautiful,whether it’s a differencein culture, ethnicity, reli-gion, language, or ourphysical, emotional ormental lives. Differences,however, can be fright-ening... to medical pro-fessionals as well as thegeneral public. Fear ofdifferences is usuallyfueled by the unknown,the misinterpreted, or themisunderstood. It is thegoal of the DiversityCommittee to raise aware-ness and educate allaround the issues of di-versity. We must includethe needs of children andfamilies with chronicmedical challenges inthat work. We, as a com-mittee, must learn moreabout this population,just as we would aboutany other diverse group.

Caring for children withmultiple medical issuescontinued from page 9

MGH celebrates PastoralCare Week

Imagining peace

Information tables, refreshments, andFilipino art display

Wednesday, October 13, 200410:30am–2:00pm

Main Corridor

Charlie King and Karen Brandow, musical storytellers and political satirists

Wednesday, October 13, 200412:00–1:00pmMain Corridor

The Blessing Of The Hands

Thursday, October 14, 20046:30–8:00am; 11:30am–1:00pm;

3:00–5:00pmThe MGH Chapel, Ellison One

All are welcome

The MGH Chaplaincy seeks to meetthe spiritual and religious needs of patients,families, and staff of all faith traditions andthose of no religious affiliation. If you would

like to speak to a chaplain, call theChaplaincy directly at 617-726-2220 or ask

your nurse to relay your request

The Chaplaincy has resumedEpiscopal services in the MGH Chapel

Tuesdays at 2:30pm

caring headlines - october 7, 2004 - crossing the culture ... · sengers and prophets beginning...

Documents