December 2011 Honors Graduates

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Lindy Kay Beyer

Rethinking the Professional Image of Nursing: A Content Analysis of Nurse-Authored Blogs

Advisor: Janna Dieckmann, PhD, RN, Clinical Associate Professor

Statement

The concept of the body affecting the mind has been around since the written word was invented. Consider this quote from the Buddha (563-483 BC): “To keep the body in good health is a duty; otherwise we shall not be able to keep our mind strong and clear.” Although I have had the good fortune to be healthy and have access to health care for a good majority of my life, I have also been witness to how devastating an illness can be to a person and their family. At the age of 13, I was probably too young to understand that my mother‟s death from cancer was not an isolated event happening only to me. Indeed, it took me another 14 years and a Peace Corps assignment to discover that people, everywhere in the world and at any given moment, had a loved one battling an illness or were fighting their own illness. At the age of 27, I was living in an isolated village in the mountains between the Kyrgyz and Uzbek borders, and health literacy in this area is extremely low. Consequently, ill health is extremely common and the medical resources available to treat people mostly come from foreign aid or grants. Living in this environment allowed me to really think about my priorities in life. I had that „eureka!‟ moment where it suddenly became very obvious to me that quality of life is heavily dependent on one‟s degree of health, and I wanted to take some responsibility for helping my fellow humans attain a higher quality of life through offering support during convalescence and education about disease prevention. Nursing was the obvious career choice for me at that point, and I absolutely love the profession- we are a perfect match!

Abstract

Nursing has suffered from a poor image since the 1800’s (Fletcher, 2007), which has been perpetuated by the media, physician influence, and stereotypes. Image problems have also been implicated in contributing to the nursing shortage. Beginning with Nightingale’s assertion that nursing is a scientific profession with a distinct body of knowledge requiring training, several efforts have transformed the modern landscape of professional nursing: educational requirements have evolved, professional improvement campaigns are progressively being adopted at the institutional level, and image-enhancing advocacy groups work towards correcting misperceptions and stereotypes in the public eye. Few studies have examined nurse-authored media with respect to image, and this paper uses using grounded theory (Glaser & Strauss, 1967) and content analysis (Cole, 1988) to describe how nurses represent their profession via Internet blogs. A sample of 101 blog posts containing information about the professional life of the nurse-author revealed that nurses rarely blogged about the image of nursing (24.85%), with few examples related to actual experience (6.45%). Overall, 54.51% of content used positive or neutral descriptors of nursing, indicating that nurse-authored blogs do not contribute to the poor image of nursing. Furthermore, the experiences nurses blog about do not reinforce the idea that nursing has a poor image. Considering that the theoretical bases for the poor image argument were formed 20-30 years ago when nursing was a very different profession, this study indicates to a need to reevaluate the idea that modern nursing has a poor image.

Kristin Bonstingl

Recognition of an Emerging Disorder: Are Nursing Students Educated to Identify and Refer Muscle Dysmorphia?

Advisor: Laura McQueen, PhD, RN, PMHCNS-BC, Clinical Associate Professor

Statement

I was in high school when my Mom was diagnosed with cancer. Her experience affected me greatly; I felt powerless as I watched someone I cared about suffer. I feel thankful and blessed that she survived and can share many new and wonderful moments with me now. Her fight directed me to volunteer as an Emergency Medical Technician (EMT) towards the end of my high school career and I have fallen in love with health care and helping others since. As nurses we serve in a truly unique and privileged role. We interact with individuals at some of their most vulnerable moments. Nurses have the power to influence a person‟s experience in a positive way by understanding the patient as a person and all of the many facets that encompass their life. My Dad always told me that if I found a job that I loved, then I would never work a day in my life; nursing has proven to be the perfect fit for me.

Abstract

Muscle Dysmorphia (MD) is a body dysmorphic disorder characterized by the obsession to gain large amounts of muscle mass while still perceiving oneself as too small. Individuals with MD have a skewed bodily perception and thus work toward unrealistic goals. MD is associated with anabolic steroid use and disrupted psychosocial processes in order to obtain established ideals. These behaviors often have serious health implications including renal failure, cardiac risks, and damaged self-esteem. The disorder is disproportionately high among the male population. Due to the population it largely affects, as well as the fact that those with MD often maintain a healthy outward appearance, individuals with MD may be largely under-diagnosed and under-treated. A descriptive analysis was used to examine responses from a survey conducted on a sample of nursing students. Student understanding of the concept of MD was assessed before and after a brief educational intervention. Analyses were used to compare answers before and after the intervention to assess the impact of the intervention on student understanding of MD. As these nursing students will soon enter the clinical arena, they are likely to encounter individuals at risk for MD. Responses provide information on students’ existing knowledge base and whether they are currently prepared to recognize and refer individuals with and at risk for MD. The survey introduces a brief educational component and analyses of responses before and after the educational intervention support that even a brief introduction to the topic has a positive impact on awareness.

Kristie Anne Brown

Decision Making about Prophylactic Surgery in Families with a BRCA Mutation: One Family’s Story

Advisor: Marcia Van Riper, PhD, RN, FAAN, Associate Professor and Chair Family Health Division

Statement

It has always been a passion of mine to help people. The nursing profession allows me to live this dream while also fostering creativity. Being a nurse allows you to share a relationship with a patient that no other health care team member can replicate. It is my ultimate hope that nursing gives me the opportunity to make a difference.

Abstract

National Institute of Cancer estimates that a woman’s lifetime risk of developing breast cancer is 12.2%. However, in families with an inherited form of breast and ovarian cancer, a woman’s risk of breast cancer is 40% to 85%. Moreover, her risk of ovarian cancer is 25% to 65% if she is a BRCA1 carrier and 15% to 20% if she is a BRCA2 carrier. Each year, a growing number of women in the United States undergo genetic testing to see if they carry a BRCA mutation. Those who test positive are faced with a number of decisions, including the decision to have prophylactic surgery. Despite data showing a significant reduction in both breast and ovarian cancer risk among BRCA carriers who undergo prophylactic surgery, most BRCA carriers choose to undergo increased surveillance, a less effective risk reduction approach. The main purpose of this study was to explore decision-making about prophylactic surgery in a family with a known BRCA mutation. The guiding framework used in this study was the Family Management Style Framework. Interviews were conducted with four sisters from one family; initial interviews were done in 2002, follow-up interviews were done in 2011. In this family, the decision to undergo genetic counseling was a family decision. However, decisions about genetic testing and prophylactic surgery were very individualized. These findings highlight the need for nurses to be aware of factors that may influence the decision-making process, as well as factors contributing to negative consequences at both the individual and family level.

Courtney B. Wolff

Caring for Seriously Ill Children: How Pediatric Nurses Cope

Advisor: Diane Yorke, MBA, PhD, RN, CPNP, Clinical Assistant Professor

Statement

Unlike many people, I didn‟t always know that I was going to become a nurse. I graduated with my first degree in journalism and English from UNC Chapel Hill, and it wasn‟t until I began volunteering for a local crisis center that I felt pulled to be a nurse. Through my volunteer work I met several nurses and was so impressed with their compassion, intelligence, and confidence. I decided right then that I wanted to be in a position to be that kind of person for others in need. I can‟t wait to get started in a career that requires grace and selflessness alongside the ability to stand up for those I have the honor of caring for.

Abstract

The objective of this study was to investigate coping mechanisms used by nurses who provide care for pediatric patients with life-threatening conditions and to explore the relationship of depressive symptoms with the nurses’ self-reported coping. The Zung Self-Rating Depression Scale was administered to two nurses who work with seriously ill children at UNC Hospitals. These nurses then participated in a semi-structured interview regarding the stress they experience at their jobs, as well as the adequacy or lack of coping mechanisms they use. Additionally, these participants were asked about how their working environment supported them in coping with job stress. Both nurses had results on the Zung Self-Rating Depression Scale that indicated they were not depressed. They also reported using coping mechanisms and having support in the workplace that were adequate for dealing with their job-related stress. However, both nurses also reported that both their personal coping mechanisms and the support from their employer could be improved. With this small sample, no firm conclusions can be drawn, although the results suggest that nurses who have adequate coping mechanisms may also have lower scores on the Zung Self-Rating Depression Scale. Learning more about the coping mechanisms of pediatric nurses, as well as the types of support they feel would help them cope better, is important in order to develop and provide workplace interventions that could assist nurses in dealing with their job-related stress. These interventions could potentially alleviate symptoms of depression and improve morale and nursing practice.