Diversity and education of the nursing workforce 2006-2016.

BACKGROUND: The Institute of Medicine (IOM) report, The Future of Nursing, included recommendations to increase nurse diversity, the percent of nurses obtaining a bachelor's degree, and inter-professional education. PURPOSE: The purpose of this paper is to report the progress toward achievement of these recommendations. METHODS: We used a longitudinal, multi-state data from four cohorts of nurses newly licensed in 2004 to 2005, 2007 to 2008, 2010 to 2011, and 2014 to 2015 to examine and compare the trends. FINDING: The percentage of males who became licensed increased, from 8.8% in 2004 to 2005 cohort to 13.6% in the 2014 to 2015 cohort. The percentage of white-non-Hispanic nurses who were licensed decreased from 78.9% in 2007 to 2008 to 73.8% in 2014 to 2015. These differences primarily reflect an increase in white-Hispanic nurses. More nurses are obtaining a bachelor's degree as their first professional degree, from 36.6% in 2004 to 2005 cohort to 48.5% in 2014 to 2015 cohort. About 40% of the 2014 to 2015 cohort reported that they learned to work in inter-professional teams. Collegial nurse-physician relations had an upward positive trajectory over time increasing almost 7%. DISCUSSION: The diversity and education of new nurses have increased, but are short of meeting the IOM recommendations.

Should Dual-Energy X-ray Absorptiometry Technologists Estimate Dietary Calcium Intake at the Time of DXA?

Adequate calcium intake is essential for bone health. Calcium is obtained from dietary sources and supplementation. Knowing the daily dietary calcium intake is helpful in deciding on the need for supplementation. Dietary calcium intake can be estimated quickly and accurately using an approach recommended by the National Osteoporosis Foundation. We sought to evaluate the usefulness of estimating dietary calcium intake by a technologist at the time of attendance for dual-energy X-ray absorptiometry (DXA) scanning. We conducted a retrospective survey of results on estimated dietary calcium intake in adults attending our DXA unit over 2 years (n=5569). We assessed intake with reference to the specifications of the Institute of Medicine according to sex and age. The average intake was 736 mg daily: Young adults had higher intakes than older adults (p<0.001), and men had higher intakes than women (p=0.017). According to Institute of Medicine's specification, we estimate that nearly 45% of Irish women need supplemental intake of 500 mg daily but <4% need supplemental intake of 1000 mg daily. Younger adults are apt to have intakes within, or higher than, the requirement. Having DXA technologists estimate dietary calcium intake at the time of DXA scanning may provide helpful information to the referring clinicians about the need for supplementation.

A Time and Place: The Role of Social Workers in Improving End-of-Life Care.

Americans are living longer, but dying after a prolonged period of management of multiple chronic illnesses and functional disabilities. Despite waves of public and professional activity targeted toward improving care for the dying and supporting the families, gaps in care and challenges in end-of-life care persist. Contentious issues such as the so-called "death panels" or physician payment for discussion of advance directives and care wishes at the end of life; aid in dying; and regarding individuals who actively choose death (case of Brittney Maynard) are continually debated in the public media. Progress toward improvement in the experience of dying remains incremental and change has been slow. With the release of a second Institute of Medicine ( 2014 ) report devoted to what it means to die in America in the 21st century, momentum and opportunity for change may increase. If this is to happen, social workers will need to deliver the range of biopsychosocial care that patients and families so desperately need. However, holistic care of the individual will only improve, if the nation also addresses ongoing systemic problems in financing, policy, and service delivery in end-of-life care.