In This Issue

NJNI’s Future Takes Shape at National Advisory Committee Meeting
NJNI Scholar Helps Address Social Isolation Among the Mentally Ill
Alumni Update
Collaborative Learning Community Gets Underway for 2013-2014
Did You Know..?

NJNI’s Future Takes Shape at National Advisory Committee Meeting

Attendees at the NJNI national advisory committee (NAC) meeting in October 2013 included, clockwise from left, NAC members Heather Howard and Susan Walsh; NJNI Program Director Susan Salmond; NAC members Dana Egreczky, Arnold Speert, Sonia Delgado, Ruben Fernandez, and Peter Inverso; NJNI Deputy Director Jennifer Polakowski; NAC Chair Mary Ann Christopher; RWJF Senior Program Officer Maryjoan Ladden; and NJNI Program Director Aline Holmes. Also serving on the NAC are Catherine Alicia Georges, Penelope Lattimer, Marcella McKay, Mary Sibley, and Mary Wachter.

Leaders of the New Jersey Nursing Initiative (NJNI) gathered in October at the Robert Wood Johnson Foundation (RWJF) to discuss what the future holds for the Initiative in its “NJNI 2.0” phase.

Newly appointed program directors Aline M. Holmes, MSN, RN, and Susan W. Salmond, EdD, RN, ANEF, FAAN, were joined by members of the national advisory committee (NAC) for the day-long meeting. It was devoted to strategic planning as NJNI builds on its support for 61 New Jersey Nursing Scholars who are pursuing, or have completed, master’s or doctoral degrees at  nursing programs in the state. They are now poised to assume nurse faculty roles in New Jersey.

RWJF and the New Jersey Chamber of Commerce Foundation launched NJNI in 2009 to address the state’s nurse faculty shortage and help avert the projected shortage of more than 23,000 nurses in New Jersey in less than two decades.

NAC Chair Mary Ann Christopher, MSN, RN, FAAN, welcomed attendees, who were then introduced to Holmes and Salmond by RWJF Senior Program Officer Maryjoan D. Ladden, PhD, RN, FAAN, setting the stage for the program directors and their deputy, Jennifer Polakowski, MPA, to lead a discussion of NJNI 2.0 priorities, including:

  • Communications efforts such as a website redesign and social media outreach;
  • A toolkit for the Faculty Preparation Program that disseminates lessons learned;
  • A Faculty Development Program that can provide sustainable professional development opportunities for nurse faculty in New Jersey;
  • Enhanced partnerships with other organizations to advance NJNI goals; and
  • Academic leadership that will attune nursing education to community-based and population health.

“What skills do nurses need now, and five years from now?” Holmes asked. “We’re figuring out dedicated education units, but we need to figure out how to create community education units, because that’s where so many nurses are going to be practicing.”

“We’re embracing the reality of health care,” Salmond added. “What does nursing education need to do? We’re teaching in traditional ways. As an educational community in New Jersey, NJNI needs to lead the shift to the educational needs of tomorrow, which is already here today.”

NAC members weighed in with expert perspectives on a number of topics, including efficiency and safety issues, interdisciplinary approaches to care, new core competencies for front-line nurses, cultural dimensions of care, encouraging a more responsive regulatory system, and incorporating leaders from the insurance industry and other business fields into NJNI’s work.

“Ultimately, we want to create a brain trust to look at all of these issues and help move nursing to a new realm,” said Salmond.

After the meeting, Christopher said she sensed “a lot of momentum from the group. All of the ideas discussed represent an opportunity to transform the health care system at a time when it’s critically important to do so.”

NAC member Sonia Delgado, MGA, said, “It was exciting to see people thinking outside of the box, getting ahead of the curve, and thinking about the value nurses bring to health care. I’m glad that people understand the need to think big.”

“The group was engaged on bridging the gap between academia and practice, and developing new competencies,” Holmes said. Salmond added, “There was recognition that the future is a different health care world. We’re going to have to redesign education. We want to build on the past and look at where nursing education must be.”

Ladden called the NJNI 2.0 objectives “a perfect next step. They build on what NJNI did with the Faculty Preparation Program, and really take the Initiative where it needs to go.”
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NJNI Scholar Helps Address Social Isolation Among the Mentally Ill

Front-line experience leads RWJF Scholar to warn that failing to focus on social integration and interaction may put mental health patients at risk.

“People with mental illness have much more going on in their lives than just their mental illness.”

It was a realization Sheila Linz had early in her nursing career, she said, because she spent many years working closely with people struggling with severe cases of schizophrenia, bipolar disorder, and other mental health problems. But as the treatment system shifted its emphasis from institutional settings to independent living, Linz, PhD, PMHNP-BC, RN, began to worry that a critical component of mental health was getting lost along the way: social interaction.

That concern led her to choose social isolation in the severely mentally ill as her research focus when she started her PhD program at Seton Hall University as a Robert Wood Johnson Foundation New Jersey Nursing Initiative (NJNI) New Jersey Nursing Scholar.

“When I was younger, I worked in a facility where a lot of people lived, and we had social groups, entertainment, and things for people to do on weekends,” Linz recalled. “But the model is moving away from that. People like to live in their own apartments, and it’s also more affordable. As a nurse and a nurse practitioner, I went into the homes of people with severe mental illness, and they looked very lonely to me. They would always be sitting in their apartments, watching television by themselves. It seemed to me that this was not good for their mental health, and it also left a whole lot more time for their delusions and for responses to their voices.”

Midway through her PhD work, Linz collaborated with Bonnie A. Sturm, EdD, RN, an associate professor of nursing at Seton Hall University, on “The Phenomenon of Social Isolation in the Mentally Ill,” a paper that consolidates a number of scholarly perspectives and analyses. It was published in the October issue of Perspectives in Psychiatric Care.

“In one way, more people are getting services, because you’re bringing services to the home,” said Linz, who graduated in May—among the first group of New Jersey Nursing Scholars to complete their PhD programs—and now teaches at Seton Hall. “But because of that, people don’t have any real need to leave their homes. There was a situation being created that I thought was pretty serious, especially since it’s so difficult for people with mental illness to be accepted into any kind of community activity, because there’s so much stigma about mental illness.”

A Link Between Social Isolation and Physical Health

Linz said her PhD work was also shaped by research showing that people with severe mental illness live 25 years less, on average, than the general population. “And this was not because of suicide,” she said. “There were a lot of metabolic disorders, and it could not be explained totally by their medications. I also saw that there was a lot of research about the general population having early morbidity and mortality due to social isolation. A lot of studies showed that social isolation was as much of a predictor of mortality, or a risk factor, as smoking or drinking.”

“I came to see social isolation as a problem not only affecting mental health, but also physical health, which is another huge problem,” Linz said.

The paper offers solutions, and describes the implications of implementing them for nursing practice. “It talks about successful methods to help people with severe mental illness engage with the outer world and have a better sense of who they are,” Linz said. “There are also suggestions for what the practitioner can recommend, such as volunteering, or seeking out activities, like art classes or poetry readings, that engage the patients around their interests and their cultural identification.”

“A lot of people with severe mental illness don’t even think they’re sick,” Linz added. “Those are the people who don’t go to medical appointments and end up homeless, or they’re back and forth between hospitals. These are the people who have treatment teams going to their homes. For them, there isn’t enough value placed on the role of social interaction and social integration in the healing of mental illness.”

Much of the information in the paper became part of Linz’s literature review for her dissertation, which explored how the problem of social isolation manifested itself in a group of people being served by the mental health care delivery system known as assertive community treatment, or ACT.

“These are multidisciplinary teams, including a nurse, and the team meets every morning to discuss each of their clients before individually going to the clients’ homes,” Linz said. “These teams have done well keeping people out of the hospital, but there are areas such as social integration where they have not done as well. It’s not a priority.”

Speaking to workers on seven different ACT teams from three agencies in two states gave Linz “a front-line perspective on how they define social integration, how they facilitate it, the barriers they face, how they overcome barriers, and what their own ideas are about ways the model could be changed. I got a lot of very interesting information.”

Read the study. Learn more about the New Jersey Nursing Initiative.

Reproduced with permission of the Robert Wood Johnson Foundation, Princeton, N.J.
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Alumni Update

Welcome to the first installment of the new Alumni Update feature. Here’s what several New Jersey Nursing Scholars have been doing since graduation:

  • Tony Malek (2012 alumnus), MSN, RN, CBN, is working in Newark at Beth Israel as an observation unit nurse practitioner to expedite discharge and lower 30-day readmission rates. He recently attended the American Association of Nurse Practitioners leadership conference in Las Vegas.
  • Tracy Perron (2013 alumna), PhD, MSN, RN, published an article, “Peer Victimization: Strategies to Decrease Bullying in Schools,” in the February issue of the British Journal of School Nursing. She also worked with the New Jersey State Nurses Association on presentations in May about the impact of the state’s new anti-bullying law on school nursing, and served over the summer with Collaborative Learning Community Facilitator Diane Billings, EdD, RN, FAAN, on a Sigma Theta Tau International task force on faculty skills development programs.
  • Shelby Pitts (2012 alumna), MSN, RN, has a full-time faculty position in Newark at Rutgers School of Nursing. She is teaching Community Health Nursing and Foundations.
  • Latoya Rawlins (2011 alumna), MSN, RN, served as a panelist for the Collaborative Learning Community webinar on choosing a doctoral program. She is pursuing a doctor of nursing practice degree at Rutgers School of Nursing.

If you are a New Jersey Nursing Scholar alumnus, please let NJNI know what’s new with you, so you can be featured in an upcoming issue of the newsletter. Send your news to Deputy Director Jennifer Polakowski via
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Collaborative Learning Community Gets Underway for 2013-2014

NJNI’s Collaborative Learning Community (CLC), facilitated by Diane Billings, EdD, RN, FAAN, has gotten off to a busy start in the new academic year, with webinars on promoting a spirit of inquiry in academic nurse educators, choosing a doctoral program, and workplace bullying, as well as a two-day workshop devoted to the National League for Nursing Certified Nurse Educator (CNE) exam.

“It’s exciting that the CNE workshop was open to broader audiences—scholars, faculty, and university leaders,” Billings said during a break between sessions, held in October at RWJF.

Presentation materials from the fall webinars are available online. The next CLC event will be a workshop on integrating nursing informatics into the curriculum. The workshop will be held on February 7, 2014, from 9 a.m. to 4 p.m. at RWJF.

CLC participants should also mark their calendars for webinars on March 7 (technology in learning) and April 23 (helping the “challenging student”), as well as NJNI’s annual meeting, March 12-14 at RWJF, which will include a CLC session on curriculum redesign.
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Did You Know..?

NJNI has a key role in the New Jersey Action Coalition (NJAC), which helps the Future of Nursing: Campaign for Action implement recommendations from the Institute of Medicine’s landmark 2010 nursing report as part of a nationwide effort to transform nursing and the delivery of health care in America.

NJAC recently announced that it has received funding of $1.6 million from the Centers for Medicare and Medicaid Services (CMS) to develop, implement, and evaluate an RN transition-into-practice residency model for long-term care (LTC) facilities in New Jersey. Working with the Health Care Association of New Jersey and volunteers from NJAC’s education pillar, NJAC will recruit 50 preceptors and 50 new nursing graduates for this 12-month residency.

NJAC hopes that the effort will improve care for LTC residents and help stabilize the state’s RN workforce. New Jersey’s readmission rates for geriatric adults with chronic diseases are among the highest in the country, and the 2010 turnover rate for staff nurses in New Jersey LTC facilities was 37.7 percent—higher than in other sectors of health care.

NJAC co-lead Edna Cadmus, PhD, RN, NEA-BC, FAAN, and NJNI Program Director Susan W. Salmond, EdD, RN, ANEF, FAAN, who is also co-chair of NJAC’s education pillar, will serve as co-investigators for the residency project, with the Rutgers College of Nursing in Newark taking the lead in overall management of the CMS funding.

“With a prestigious interdisciplinary team, along with others who will be participating with us over the next 30 months, we are excited about the impact we can make for long-term care residents in New Jersey,” Salmond said.

Learn more about NJAC online.
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