Janice Collins-McNeil

Aging workforce: Retaining valuable nurses.

T he impending retirement of RN baby boomers is now a workforce reality that could have a profound impact on U.S. healthcare.1-3 The CDC and the National Institute for Occupational Safety and Health projected that in 2010, middle-aged and older workers would outnumber younger workers.4 Thus, baby boomer RNs (those born between 1948 and 1964) are now in what has been traditionally known as the retirement years. Nurse administrators and educators are challenged with the task of retaining these knowledgeable, skilled nurses while aggressively recruiting generation X and millenial nurses. Developing initiatives to retain nurses in the workforce and recruit young people into the profession is an urgent national priority, especially with the healthcare reform bill that will add approximately 32 million newly insured patients into the healthcare system.5 However, if the U.S. healthcare system continues to lose aging RNs, Americans could be facing a major public health crisis. The lack of qualified nurses increases the risk of poor patient outcomes that can have a direct effect on increased hospital costs. More important, nursing shortages have been linked to increased mortality, staff violence, accidents/injuries, cross infection, and adverse post-op events.6 The more urgent and preventable crisis is the population imbalance in the nursing workforce. A recent study indicated a 62% increase in the number of young nurses entering the workforce between 2002 and 2009, a rate not seen since the 1970s.7 If the recent surge in recruiting younger nurses continues, Americans can anticipate a much larger group of novice nurses. As baby boomer RNs continue to age and leave the workforce, the greater loss for nursing is the intellectual capital and clinical expertise that serves to improve quality patient outcomes, educate new nurses, and inform the discipline of new clinical problems that warrant investigation. Therefore, it’s imperative that nurse leaders and educators make commitments to develop and implement innovative strategies to retain older, experienced nurses while continuing to recruit younger people into the profession.8,9

Depression and Functional Status Among African American Stroke Survivors in Inpatient Rehabilitation

PURPOSE To examine the prevalence of poststroke depression (PSD) among African American stroke survivors and the association of depression with functional status at inpatient rehabilitation facility (IRF) discharge. METHODS Secondary data analysis was conducted of a patient cohort who received care at 3 IRFs in the United States from 2009 to 2011. Functional status was measured by the Functional Independence Measure (FIM). Multiple linear regression models were used to examine associations of PSD and FIM motor and cognitive scores. RESULTS Of 458 African American stroke survivors, 48.5% were female, 84% had an ischemic stroke, and the mean age was 60.8 ± 13.6 years. Only 15.4% (n = 71) had documentation of PSD. Bivariate analyses to identify factors associated with depression identified a higher percentage of patients with depression than without who were retired due to disability (17.1% versus 11.6%) or employed (31.4% versus 19.6%) prestroke (P = .041). Dysphagia, cognitive deficits, and a lower admission motor FIM score were also significantly more common among those with depression. There was no significant relationship between depression and functional status after adjusting for patient characteristics. CONCLUSIONS In this study, 15% of the African Americans who received rehabilitation after a stroke had documentation of PSD but this was not associated with functional status at discharge.

Understanding the Correlation between Physical Activity and Clinical Depression in Women: A Review of the Literature

In an effort to understand the correlation between clinical depression and physical activity, a systematic literature review was conducted. Major Depressive Disorder/Clinical depression is a mental illness that can be expensive and debilitating to sufferers. It poses a substantial burden worldwide when not treated effectively clinical depression is likely to lapse into a chronic disease as reported by CDC in 2011). At least 350 million people live with clinical depression and it is the leading cause of disability worldwide as reported by WHO in 2012). It affects not only the person with clinical depression but their families too. The World Health Organization (WHO) also reported that major clinical depression was ranked eighth in low income countries but was first place in middle and high income countries.

Contributing Factors to Obesity in African American Children within the United States

From 2007 to 2011 obesity has shown an increased prevalence among children within the United States. According to a report by Bell et al., childhood obesity affects approximately 12.5 million children aged 3 years to 12 years of age. Since the 1980s childhood obesity within the United States has tripled with the rate starting at 5% of African- American children (AA) and now it is 15%. According to the latest statistics from the United States Department of Health and Human Services, Office of Minority Health Report, the percentage of obese African American children between the ages of 6 to 17 years old between 2007-2008 was 22.4%. The health impact on African Americans regarding childhood obesity has sparked increasing concerns about the future health and wellbeing of this population. Causes of African-American childhood obesity are complex and vary considerably in nature. Childhood obesity has attracted the attention of many researchers who have investigated the relationship between childhood obesity and a variety of related factors Davis et al. A review of literature on the causes and driving force behind African American childhood obesity will provide a strong foundation in which researchers may utilize in the development of population specific interventions.