The Des Moines Register from Des Moines, Iowa • Page AD2

Page 2AD Sunday, May 5, 2013 State Edition The Des Moines Register Tips for interacting with your nurse tion for us. We just want to take care of you better." Writing down questions is beneficial, Mielke said. "Sometimes the doctors come in and it's quite overwhelming to listen to all they have to say," she said. Patients also can ask a nurse to stay to explain what the doctor said. Many of the residents at Luther Care Services in Des Moines have lived at the center for two to five years or more, said Dot Donaldson, director of nursing.

She describes the patient-nurse relationship as a partnership. Nurses need to get involved with residents to know their likes and dislikes, and daily routines and activities. Do they like to sleep in or wake up early? Prefer baths over showers? Donaldson said nurses can help patients understand information and educate them on the best options. If patients have trouble understanding a nurse due to an accent or language barrier, they can request another nurse to help. And if nurses don't have an answer to a question, they can work with the family to find the answer.

"It should be an open book," she said. Shared respect and flexibility also helps, Donaldson said. "I always tell my family members it's an honor to have their parent here," she said. By Estela Villanueva-Whitman Special to the Register From long-term care to clinic and hospital settings, nurses are typically the first health care professionals patients encounter. Building a positive nurse-patient relationship can help ensure the best possible care throughout the process.

Nancy Mielke, clinical nurse manager on the cardiac stepdown unit at Mercy Medical Center-North Iowa in Mason City, recommends that patients communicate their top three goals. That may be getting well, finding what caused a health condition or learning about the treatment plan. "We really want them to take charge of their care, if possible," she said. Marna Denny, a private nurse at Des Moines Orthopaedic Surgeons in West Des Moines, agrees that patients should play an active role and take charge of their bodies. When physicians recommend lifestyle changes, such as diet and exercise, patients should be prepared to follow through and take the advice seriously.

Being honest is also important, Denny said. "Tell us the truth: your habits, your history, what you've tried," said Denny, who has worked with some patients for more than 10 years. "What's an awkward question for you is not an awkward ques I urse in Iowa City, performs an Iowa City, bryon houlgravethe exercise on a dummy in a simulation lab at the University of register TIPS FOR YOUR PATIENT-NURSE RELATIONSHIP 1. Tell your story well. 2.

Be clear and accurate about your symptoms. 3. Relate your history or have a family member do so. 4. Be honest, not embarrassed, about medical problems.

it.t.bi.ud.ikk.iiii.i.biALii.i.bi.Vi A smooth transition St. Luke's College in Sioux City and Dordt College in Sioux Center were ahead of the trend when they began a partnership in 2000 to transition students to a BSN program and signed an agreement in 2009 to improve student satisfaction with the process. The biggest benefit is a seamless transition to financial aid through Dordt. Previously, students in that region who wanted to complete a BSN had to look elsewhere. Online programs weren't as accessible and students wanted face-to-face instruction.

"We were starting to lose that population," said Susan Bowers, member of St. Luke's faculty. "It was becoming an unmet need," added Jodi Kolar, chairwoman of St. Luke's nursing department. Students can live on the Dordt campus and participate in extra-curricular activities there.

First-year classes are taken at Dordt. The following two years, students take classes at St. Luke's three days a week and two days on the Dordt campus, taught by St. Luke's faculty. The schools are 89 miles apart, round-trip.

Kolar said students are happier with the arrangement. About half of the nursing students complete the entire program. The rest enroll only in the associate's degree portion at St. Luke's 45 percent of those students declare an intention to get a BSN within five years. Ultimately, the issue comes down to patient care, Loes points out.

Recent studies reconfirm that there is less risk for patients when nurses are prepared with a BSN. "It's been an excellent debate and dialogue and I do believe as a profession of nursing in the state of Iowa, we are moving forward in this discussion," he said. that would move more nurses to become BSNs," Loes said. The Iowa Board of Nursing had considered forming an educational study committee to discuss the operational implications of the proposal, but the plan is on hold as the board goes through a leadership transition. That may also delay implementation dates, originally set for 2015.

Access to programs is one barrier in Iowa. National figures reflect more urban environments, which have easier access to BSN programs, Loes said. Iowa has one public university offering a bachelor's degree in nursing, and the rest are private or associate degree programs through community colleges. Although the number of online BSN programs has grown, community colleges are less expensive and conveniently located. Two-thirds of new graduates come from community colleges, according to the most recent Iowa Board of Nursing "Trends in Nursing" report.

Another drawback to pursuing a bachelor's is that nursing salaries are not necessarily tied to a degree. All nurses take the same licensure exam and perform similar duties when they enter the profession, Loes said. A mobile career Career mobility is one reason nurses should obtain a bachelor's degree, said Rita Frantz, dean of the University of Iowa College of Nursing and co-chairwoman of the Iowa coalition. "If they have stopped their education with an associate's degree, there's going to be a ceiling, and a fairly low ceiling, as far as where they can move to within any health care organization. With the evolution of our health care system and the kind of demands and requirements that are going to be placed THANK YOU "We felt there needed to be an external factor that would move more nurses to become BSNs." NEAL LOES Vice-president and chief nursing officer at Mary Greeley Medical Center.

Since January 2012, Mary Greeley has required nurses to earn a bachelor's degree within 10 years of hire. upon them in the health care world, they are personally going to find it very difficult to maintain the necessary skills to advance at the same pace that the health care system is changing," she said. Roles such as case managers and navigators aren't part of an associate's program. Without the skill set needed to move into more complex roles, nurses will remain in an entry level position, Frantz said. Getting a BSN is also the first step in solving a shortage of nursing faculty to teach new nurses, which would also allow programs to expand enrollment.

Many schools require a master's degree to teach, yet only 5 percent of Iowa nurses hold the degree and only 0.7 percent hold a doctoral degree. The task force has determined there are adequate numbers of educators to handle the potential influx in enrollment due to the effort. It is also researching models of education that provide a seamless transition from associate's degree to BSN. Robin Klaaren, a registered Iowa Hospitals and Clinics in GOAL Continued from Page 1AD Loes said. But some employers already give hiring preference to nurses with bachelor's degrees.

Since January 2012, Mary Greeley has required nurses to get a bachelor's degree within 10 years. The task force has presented a proposal to the Iowa Board of Nursing, recommending that nurses be required to earn a BSN within five years of employment. "We felt there needed to be an external factor Ipi YfS EXCELLENCE CARE i VA Central Iowa Health Care System (VACIHCS) would like to congratulate all nominees and recipients on the prestigious honor of being recognized as one of Iowa's 100 Great Nurses! Currently, VACIHCS is seeking RN's, LPN's and Nursing Assistants (NA's) to join in our mission to provide quality health care to our Nation's Heroes through Integrity, Commitment, Advocacy, Respect and Excellence (ICARE). Please see our facility wide announcements on www.usajobs. gov.

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