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Hundreds of nurses and their colleagues at ChristianaCare gathered in a conference room at Christiana Hospital and listened through a livestream across the organization’s campuses and practices for an announcement they’ve been anticipating for many months. “For your commitment to nursing excellence and quality care, we are thrilled to recognize ChristianaCare with its fourth consecutive Magnet designation,” said David Marshall, JD, DNP, RN, chair of the American Nurses Credentialing Center’s Commission on Magnet Recognition. “This accomplishment is a powerful testament to your dedication to the nurses who practice there, the entire health care team, and — most importantly — the patients you serve.” Shouts erupted, balloons and streamers floated up and, in the happy commotion, there was even a little cowbell. As the only four-time Magnet-designated health care organization in Delaware, ChristianaCare has achieved this global recognition — the highest honor in nursing practice — for continued dedication to excellence and innovation, high-quality patient care and experience, nurse engagement and work culture. “Magnet designation recognizes ChristianaCare nurses are simply the best!” said ChristianaCare President and CEO Janice E. Nevin, M.D., MPH. “A fourth Magnet designation is an incredible achievement and reflects the vital importance and commitment of our nurses as we serve together with love and excellence.” ChristianaCare has more than 3,000 nurses, and they make up the largest segment of ChristianaCare’s workforce. ChristianaCare is the largest nonprofit organization and private employer in the state of Delaware. This most recent designation for ChristianaCare includes Christiana Hospital, Wilmington Hospital, ChristianaCare HomeHealth and Community Care Services, through early 2029. What it means to be Magnet “Our fourth consecutive Magnet designation means that our nurses and all of our caregiver colleagues have upheld the ANCC’s very high standards in patient care since our first recognition in 2010,” said ChristianaCare Chief Nurse Executive Danielle Weber, DNP, RN. “That is a long time to bring your ‘A’ game every day — through 15 years of change, including a pandemic — and to sustain growth in professional practice, innovation and culture. Magnet recognition raises the bar for patient care and inspires every member of our team to achieve excellence every day.” The Magnet Recognition Program — administered by the American Nurses Credentialing Center, the largest and most prominent nurses credentialing organization in the world — identifies health care organizations that provide the very best in nursing care, exceptional nurse engagement and professionalism in nursing practice. The Magnet Recognition Program serves as the gold standard for nursing excellence and provides consumers with the ultimate benchmark for measuring quality of care. The ANCC Magnet Recognition Program® has conferred Magnet status to less than 10% of hospitals and health systems in the United States. There are 621 Magnet-designated health organizations internationally. ChristianaCare was the first in Delaware to achieve Magnet designation, in 2010. For nurses, Magnet Recognition means education and development through every career stage, which leads to greater autonomy at the bedside. For patients, it means the very best care, delivered by nurses who are supported to be the very best that they can be. While Magnet is a nursing-led initiative, the designation reflects the work of caregivers across the organization. Magnet redesignation itself is a rigorous process. Health care organizations must reapply for Magnet status every four years and demonstrate adherence to the Magnet concepts for nursing excellence and engagement and measurable improvements in patient care and quality. The ANCC commended ChristianaCare on these exemplars: Advocacy for and acquisition of organizational resources specific to nurses’ well-being. particularly through the Nursing Integrative Care Program. An innovative strategy to address the shortage of certified registered nurse anesthetists in Delaware through a partnership program between ChristianaCare and Wilmington University to launch the state’s first Nurse Anesthesiology program. Outstanding nursing research engagement and growth of the nursing research enterprise especially through the Nursing Research Fellowship in Robotics and Innovation.
ChristianaCare and Partners Launch Delaware’s First Nurse Anesthesiology Program
Wilmington University, in collaboration with ChristianaCare and the support of Anesthesia Services, P.A. (ASPA), announces the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University, Delaware’s first nurse anesthesiology program. This innovative, full-time, 36-month offering leads to a Doctor of Nursing Practice (DNP) degree, preparing graduates to sit for the National Certification Exam and become certified registered nurse anesthetists (CRNAs). A CRNA (or nurse anesthetist) is an advanced practice registered nurse who administers anesthesia and provides related care before, during, and after surgical, therapeutic, diagnostic, and obstetrical procedures. The program will offer students over 2,000 hours of hands-on clinical experience in high-acuity environments across various surgical specialties, supported by partnerships with ChristianaCare, ASPA—the largest anesthesia group in Delaware—as well as other health care organizations. Students will refine their clinical skills and decision-making in state-of-the-art simulation labs while engaging in diverse clinical settings. Led by experienced practitioners and educators, the curriculum integrates anesthesiology-specific coursework with advanced nursing practice, ensuring graduates are well-prepared to meet the evolving demands of clinical practice and systemic health care challenges. “We are proud to partner with ChristianaCare and ASPA to launch this transformative program,” says Wilmington University President Dr. LaVerne Harmon. “At Wilmington University, our caring, student-centered approach prioritizes academic excellence and personal well-being. While this initiative addresses Delaware’s critical need for anesthesiology professionals, we will focus equally on fostering an environment where students can excel and grow into compassionate, skilled leaders in the evolving health care field.” “ChristianaCare is excited to partner with Wilmington University and our colleagues at ASPA in this much needed program to help address Delaware’s growing need for highly qualified CRNAs,” says Janice E. Nevin, M.D., MPH, president and CEO of ChristianaCare. “By providing advanced training and education in anesthesiology services, we are helping to develop the next generation of health care experts who will serve our community with high-quality, safe care.” The U.S. Bureau of Labor Statistics projects a 38% growth in nurse anesthetist employment from 2022 to 2032, driven by increased demand for health care services like elective surgeries. Delaware’s health care system faces similar challenges due to a shortage of anesthesiologists and CRNAs, with many nearing retirements. With 15 programs in neighboring Pennsylvania unable to accommodate all qualified applicants, the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University aims to bridge this gap, providing essential local training to meet the growing demand in the workforce. “With an emphasis on evidence-based practice and patient-centered care, our graduates will be exceptionally equipped to provide high-quality anesthesiology services in diverse health care environments,” says Wilmington University Vice President of Academic Affairs Dr. Denise Wells. “This collaboration aims to cultivate a local pipeline of skilled registered nurses who will advance their careers as CRNAs, contributing to Delaware’s workforce and the surrounding region.” “Anesthesia Services, P.A. has been leading and innovating anesthesia care delivery in Delaware for the past 37 years,” says ASPA Board Chair Li Maceda, M.D., MBA. “This joint partnership with ChristianaCare and Wilmington University allows us to combine our expertise and resources to train the next generation of anesthesia providers for the communities that we serve and exemplifies our commitment to invest in the future advancement of perioperative care.” Dr. Jacqueline Mainwaring was recently named inaugural director of the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University. “I am excited to be part of this groundbreaking initiative that will provide critical care nurses in our state with the opportunity to advance their careers and become leaders in anesthesiology care,” says Dr. Mainwaring, also an associate professor. “We are committed to creating a high-quality program that prepares our graduates to excel in today’s complex health care landscape. This program will not only address the shortage of anesthesiology professionals in Delaware and the region but will foster a learning environment that emphasizes student well-being, clinical excellence, and interprofessional collaboration.” Leaders of the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University, currently in Capability Review, are pursuing initial accreditation from the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Please note, no students can be enrolled until initial accreditation has been awarded. Below is contact information for the COA: Council on Accreditation of Nurse Anesthesia Educational Programs (COA) 10275 W. Higgins, Suite 906 Rosemont, IL 60018 Phone: 224-275-9130 Email: accreditation@coacrna.org www.coacrna.org
As Popularity of Weight Loss Medicine Soars, Professionals Caution Against “Magic Pill” Mindset
A growing weight-loss fad has been dominating headlines this summer. No, it isn’t a new type of trendy diet, exercise regimen or social media influencer-touted superfood. It’s two medications – Ozempic and Wegovy – that have skyrocketed in popularity as more Americans turn to these once-weekly injections to aid in their weight loss efforts. But, while acknowledging the drugs’ effectiveness, their intended patient populations and appropriate usage has become far more nuanced and situational, and the intended outcome of long-term weight loss and health is dependent on more than just taking either of these medications once a week. “While these medications can be helpful for some people who struggle with weight loss, it's important to remember that they are not a magic solution,” said Rebecca Shenkman, MPH, RDN, LDN, director of the MacDonald Center for Nutrition Education and Research at Villanova University’s M. Louise Fitzpatrick College of Nursing. First, it’s important to understand the components and histories of both Ozempic and Wegovy. They are prescription medications of the same drug, semaglutide, which belong “to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists, originally developed to treat type 2 diabetes,” per Shenkman. It was discovered by researchers that significant weight loss was a side effect of semaglutide. Ozempic is the 2017 FDA-approved drug used to help treat diabetes. Currently, it is not FDA approved for weight loss and typically not covered by health insurance when used for that purpose, per Shenkman, but is often prescribed off label for “weight management in certain individuals who do not have diabetes, but struggle with obesity or [are] overweight.” Wegovy was approved by the FDA in 2021 as an anti-obesity drug used for individuals living with obesity or individuals with excess weight, but not classified as living with obesity, who also have other associated health problems. “When used correctly, the drugs can have many benefits,” Shenkman said. “[Semaglutide] is shown to improve diabetes and body weight in addition to seeing improvements in cardiovascular health and risk factors.” However, “correct use” is what concerns Shenkman and other health and nutrition professionals. “Anti-obesity drugs are a valuable tool for people who have not experienced adequate benefit from self-directed or professionally directed lifestyle treatment,” she said. “However, what we are seeing more and more of now is that people are requesting anti-obesity medications without meeting eligibility criteria for drug use, [such as] body mass index and weight criteria, [or] having the foundational knowledge and application of healthy lifestyle behaviors prior to medication use.” To Shenkman’s first point, there are several factors, especially in American society, driving those who may not meet the criteria for these medicines or even truly need them to request and ultimately receive the drugs. The media’s portrayal of ideal body image is an enormous influence, which can lead to “body dissatisfaction and a desire for quick weight loss solutions,” said Shenkman. Advertisements for these drugs often promote those ideas, and even downplay side effects, making them more appealing. Intrinsically tied to body image is the struggle many individuals have with psychological issues related to food, such as emotional or binge eating. “They feel that their self-worth is tied to their weight, and they will do almost anything to lose weight, whether it be five or 50 pounds.” Shenkman said. “These individuals might believe that medication will help them control their eating habits more effectively.” Identification of such issues prior to prescription approval is something that providers need to be aware of and screen for, Shenkman said. “It is so important for providers to complete a comprehensive pre-treatment assessment of their patients who start on weight loss medications. Unsupervised or improper use can lead to malnutrition, unhealthy weight loss, or even a worsening of an undiagnosed and/or undertreated eating disorder or mental health condition.” But even users who meet all pre-treatment criteria may be turning to the drugs in haste, or believe that they alone will solve their problems, and do so quickly. “Americans are known for having that ‘quick-fix mentality’ where people often seek quick solutions to their problems, including weight loss,” Shenkman said. “Weight loss medications might promise faster results compared to lifestyle changes, which can take time and dedication.” Compounding this “quick-fix mentality” is the frustration many feel when they fail to see results after multiple unsuccessful attempts at weight management. “The abundance of information on diets, exercise routines, and weight loss programs can be overwhelming… Some may turn to medications as they seem more straightforward and require less effort to understand,” explained Shenkman. But, as health care providers know, they are far from straightforward. All drugs, including Ozempic and Wegovy, come with the potential for side effects, which can vary with the individual. Headlines this summer focused on reports of users experiencing gastroparesis, described by Shenkman as the “the slowing down or ‘paralysis’ of the digestive system and gastric (or stomach) emptying.” Though most often reported to cause nausea and vomiting, complications of gastroparesis can be quite serious. “If someone continues the medication and experiences chronic gastroparesis, complications to be aware of include malnutrition, dehydration, acid reflux, blood sugar control and even bowel obstruction,” Shenkman said. The American Society of Anesthesiology also recently issued guidance on the use of such drugs prior to surgery, given potential life-threatening complications. “When prescribing anti-obesity medication, it is the responsibility of healthcare providers to inform patients about potential side effects and risks associated with the medication,” Shenkman said. “It is also the right of the patient/consumer to ask questions and understand what they are putting in their body. A thorough discussion about benefits and possible adverse effects can help patients make informed decisions about their treatment.” Many users may also not fully understand that these drugs are usually taken long-term, even after reaching a desired weight. Stopping without the knowledge of how to keep the weight off may lead to its return. Considering the pros and cons of the drugs, Shenkman’s advice is simple. “Weight loss medications should always be used as part of a comprehensive weight management plan, which includes a balanced diet, regular physical activity, and lifestyle changes. Relying solely on medications without addressing other aspects of weight management is not likely to lead to long-term success no matter how long you stay on a medication.”
Ask our experts - Self-care a necessity for graduate students; what are programs doing to help?
Life doesn’t stop when you’re in a doctoral program. Erin Ayala, Ph.D., has done extensive research into self-care, stress, and quality of life of students, particularly those in human service doctoral programs (like medical students and those in nurse anesthesiology, psychology, and counseling). She knows the recipe for stress and burnout: • These stressful programs tend to attract high achievers. It’s already in their nature to balance several commitments and responsibilities. • These programs and professions have a high level of responsibility. • Students in these programs are frequently at an age where they are also going through significant developmental milestones (marriage, children, purchasing homes). “When you bring all of that together, it can be really difficult to prioritize time for self-care,” she said. “Prevention and health promotion are really important, and it’s not just about mental health. It’s not just about being reactive and addressing distress or burnout when it hits. The question is what can we do on the front end to help prevent negative consequences down the road.” What is self-care? Often, Dr. Ayala said, media romanticizes and glamorizes self-care with advertisements for fizzy bath bombs and manicures. “What we have found is that it is completely personalized,” Dr. Ayala said. “For women, social support is really important. Ultimately, there needs to be time to disconnect, whether it’s doing nothing, or just taking a break from your dissertation. You’ve got to give yourself permission to do that. “Nutrition, exercise, hydration, spiritual life, different people have a different recipe for what their self-care looks like. It ebbs and flows just like any exercise or meditation or spiritual practice. Some weeks we’re doing great and other times we’re not, and that’s part of the process.” Dr. Ayala’s most recent research involves analyzing qualitative data, coming from over 200 students throughout the U.S. in clinical counseling and school psychology, all high achievers in the middle of doctoral programs. She’s investigating what faculty are doing to model or not model the importance of physical and psychological wellness. “Students might know that self-care is important, but it can be hard to act on it if they're in an environment that doesn’t support it,” she said. “The biggest supportive theme that came up was faculty simply encouraging them to do it, asking their students, ‘What did you do this weekend for self-care?’ They take the time to check in with their students and give them permission to take time for themselves. That takes zero effort.” “What can we do to make sure faculty are also able to model self-care for their students? The behaviors students are picking up now pave the foundation for the rest of their career. If faculty are working themselves to the bone, it sets an expectation for their students that they are supposed to do the same. If faculty model self-care and talk about its importance, students may be more likely to do it themselves.” Dr. Ayala said when her team asked students what programs can do to support self-care, answers ranged from formal programming and talking about it in the classroom, to referrals for therapists, discounts for gym memberships, or places to meditate on campus — ways to make self-care easier to access. When students are asked what the biggest barrier to self-care is, the answer wasn’t surprising. The majority of students responded that time was an issue. “That’s a tough one because there’s only so much programs can do to minimize the amount of work required,” Dr. Ayala said. “Students have to balance all these professional responsibilities and don’t know what to give up.” Are you looking to know more about self-care and other similar topics when it comes to high education? Or, are you a journalist covering this topic and looking to book an interview? That’s where we can help. Dr. Erin Ayala is a licensed psychologist and core faculty member in the counseling psychology doctoral program at Saint Mary’s University of Minnesota. To book an interview with Dr. Ayala – simply click on her icon to arrange a time.
