Monitoring child malnutrition as an indicator of death rate
“The world’s health is human health — that’s one of the fundamental priorities of our school,” explains Sanghyuk Shin, director of the UC Irvine Infectious Diseases Science Initiative and associate professor at the Sue & Bill Gross School of Nursing. “I follow global health crises wherever they occur because if we’re to be true to our values, health inequities and the right to health are relevant to health professionals everywhere.”
As the 2024 recipient of the Athalie R. Clarke Achievement Award for Nursing Research, Shin has used his award to fund research into the ongoing health implications of the conflict in Gaza. Research fellowships are being allocated to two student applicants from across the health sciences, including nursing.
I follow global health crises wherever they occur because if we’re to be true to our values, health inequities and the right to health are relevant to health professionals everywhere.
Sanghyuk Shin
On November 6, 2023, less than a month after the total blockade of food, water, electricity and medicine to Gaza began, the UN Secretary General described the territory as a “graveyard for children.” By spring of 2024, an estimated 16,000 children had died through military violence alone, not including deaths from malnutrition and infectious diseases. A nutrition cluster survey carried out in the region by the UN World Food Programme and other nongovernmental organizations in May 2024 revealed that in the three days before the survey, 85% of children surveyed had not eaten for at least one entire day.
“In global health, we monitor children because they are typically most vulnerable to malnutrition and disease, and therefore indicative of what’s happening to the health of populations,” says Shin, an infectious disease expert and epidemiologist. “Even when a ceasefire is achieved, malnutrition is going to be a key driver of death in Gaza. Situations of malnutrition plus poor sanitation are textbook scenarios from which infectious disease outbreaks arise.”
Under the supervision of Shin and other faculty, stipend recipients will define their own research topic relating to the health of Palestinians in the occupied territories. Researchers will work from secondary and publicly available data.
“We won’t be able to do any field research,” Shin points out, “but there’s data coming out of Gaza. Applying public health and nursing principles to understanding what’s going on there now and historically—that’s how those of us working in U.S. health science settings can contribute to public knowledge and discourse.”
Families of children with cancer empowered through culturally adapted care
Clinical psychologist and pediatric pain expert Professor Michelle Fortier of the UC Irvine Sue & Bill Gross School of Nursing is zeroing in on culturally adapted care as a necessary component in improved health equity in the U.S. Her pilot program for Latinx families of children with cancer, Corazones Unidos Por Una Vida (Hearts United for Life), involved 32 families with children receiving treatment at CHOC (Children’s Healthcare Orange County). Results revealed marked increases in health literacy among the adult participants—a key element in overcoming barriers to healthcare.
As one aspect of her ongoing work on better care for children in treatment for cancer, Fortier is designing a larger study that measures the impact of cultural adaptation in healthcare provision and looks at how to go about it. “Translation alone is not enough,” she says. “The barriers to healthcare aren’t so much with the families—they’re with structures and systems and providers.”
Nurse leadership in the community
Evidence-based advocacy for families and children in Irvine, California.
Nursing informatics researcher and school nurse advocate Assistant Professor Nakia Best of the Sue & Bill Gross School of Nursing is contributing her expertise on the Irvine Child, Youth & Families advisory committee. This body of experts, professionals and community representatives drives progress and evaluates the effectiveness of the city of Irvine’s Child, Youth & Family strategic plan. Best’s most recent research focuses on the experience of school nurses, particularly during the pandemic. She has previously shown the impact of school nurses on children’s attendance at school—a metric that is ultimately linked to academic performance and opportunity.
What Makes Your Specialty Special?
All areas of nursing are recruiting to fill shortfalls. Humanitas spoke to students, new graduates, teaching faculty and practicing nurses who have chosen to work with mothers, babies and children. We asked them: What makes your specialty special?
From students and new graduates
“There is something so beautiful and indescribably special about supporting a mother while she brings life into the world. Every OB patient and every birth is different, beautiful and challenging in its own way”
Katie Thomis MS Student
“[In the NICU] I was amazed by the patients’ resilience and their ability to adapt to life, despite illness and difficult circumstances. I had the opportunity to complete my preceptorship in the NICU and I felt so lucky. Collaborating with families allowed me to create strong, therapeutic relationships, which felt extremely special and fulfilling.”
Marly Abutin BS graduate ’24
“My interest in obstetrics stems from the profound impact a labor nurse can have on families, contributing to positive beginnings for both newborns and their mothers. I recall a particularly anxious patient who required a caesarean section. Being there to reassure her in the operating room and provide comfort afterward was a pivotal learning experience. When it was time to move her to postpartum, we ran into her extended family, jumping with joy to see their new family member, and her other son, who started crying tears of joy.”
Sydney Okubo MS graduate ’24
“Nurses are essentially the front and center of patients’ care. In my personal life, I have naturally taken on the role of a support person, empowering those around me. I envision myself continuing this journey as a perinatal nurse, empowering birthing persons and their families during childbirth and the recovery period—one of the most exhilarating yet vulnerable stages of life.”
Maryam Adewunmi MS graduate ’24, Daisy Award honoree 2024
“One factor that initially drove me to a career in nursing was the passing of my nephew a few short weeks after his birth. In the NICU, I felt a sense of fulfillment caring for the patients and families there. It felt like a full-circle moment.”
Josue De La Cruz-Sevilla BS graduate ’24
“Every day feels like a birthday party when working with mothers and babies. The chance to make a tangible difference in these pivotal moments drives my passion for nursing in maternity and neonatal health.”
Mariel Fernandez MS graduate ’24
From maternity and pediatric nursing professionals
“It’s an honor being part of bringing life into the world. This is the only field where you have two patients and one of them is inside of the other. They’re both extremely important to keep in mind when providing care; we really do need a wide range of skills to care for both of them. Postpartum, we incorporate the whole family. We’re making sure that mom and baby are safe medically, but also set up for success when they leave.”
Elizabeth Augustine Perinatal Clinical Nurse, UCI Medical Center
“Academic medical centers are amazing places. Very high-risk patients, women who might have died 10 or 15 years ago, have very good outcomes now. People can have babies who previously would not have been able to. We can provide medical treatment to the fetus in utero. There are multiple specialties within our specialty; when I step into work each day, I am literally running a mini hospital. We have doctors who are double board certified, such as obstetrics and cardiology. The nurses have to maintain that range of specialist skills while we take care of two people at the same time—and one of those people, you can’t see.”
Tiara Johnson Nurse Manager, UC San Diego Medical Center
“This is a great area of nursing for someone who loves to teach. To have great outcomes, we need to teach a mom about her medication, about how to look after herself and about why we’re doing what we do, like when and why we use fetal monitoring during labor. Nurses also teach her how to care for her newly born baby—because we admit one patient, but we discharge two. Nurses have to choose the right moment to teach: nobody is going to learn when they’re in labor, or when they’ve just delivered. You need to ask them about a specific topic they’d like to focus on, and try and make sure they have access to resources. There’s a lot of teaching and a lot of patience, and you learn something every day. Even as an educator, I learn something every day.”
Johanah Carrarera Clinical Nurse Educator, UCI Medical Center
“This is an area where you can truly make a difference in someone’s life. When it’s good, it’s the best—and you need to make sure it stays the best. When it’s bad, it’s the worst. But, as a nurse and as a human being, those have also been the most impactful moments of my career, when I have made the biggest difference to someone being able to process and survive some of the hardest of times. On my soapbox, I would also say that this whole area of nursing is fabulous because it really is the cornerstone of a healthy society. The more we can do to support healthy moms having healthy pregnancies, the more we have healthy babies and children who grow into healthy adults. We literally are building healthy communities.”
Leanne Burke Director of Teaching, Excellence and Innovation, Sue & Bill Gross School of Nursing
“Pediatric nursing is a complex specialty and it’s very broad. When I started nursing it was simplistic, but if you go into pediatrics now you have so many choices: cardiology, gastroenterology, oncology, hematology, anesthesiology. These are all distinct specialities within pediatric nursing. I like the broadness of it. The other aspect is that the family is central to pediatric care. When our patient leaves the hospital, the care they get depends on their family, so the family must be prepared, and must be central to decision-making. They are with their child 24/7—we just get to visit or intrude during a critical time in their life.”
Shelley Burke Assistant Clinical Professor, Sue & Bill Gross School of Nursing
What’s Your Headline?
Humanitas asked our panel of nursing professionals: what’s the headline issue for your specialty? This is what they said…
Nurse Retention Rates Need to Rise Our maternity unit used to be a really hard place to get a job because no one wanted to leave once they started here. Since Covid, a lot of nurses have left. We lost some really good nurses. We have started research on burnout and compassion fatigue. The good thing is that the latest retention rate data is way better, not just for our unit but for the whole medical center. But we’re still trying to hire.
Johanah Carrera Clinical Nurse Educator, UCI Medical Center
Better Coordination, Better Patient Care Navigating care can be very confusing for pregnant patients. When they are high risk, they have multiple appointments, including with other hospital departments. There may be issues with transport, childcare for other children, or other pressures. I am working in a coordinator role to improve communication between our outpatient and inpatient functions, and with other hospital departments. We need to make it easier for patients to access the full range of resources for their care.
Elizabeth Augustine Perinatal clinical nurse and (project-based) lead triage nurse, UCI Medical Center
Maternity Nursing Must Tackle Implicit Bias I have never seen a physician or nurse being overtly biased toward a patient on the basis of race. It typically starts with some level of implicit bias. Black patients aren’t listened to. They and their families get viewed as adversarial, rather than as part of the team. As a Black woman, it’s not lost on me. My DNP thesis was on implicit bias in nursing. There’s a lot of work that’s been done, but there needs to be a lot more. It’s not only African American mothers facing poorer outcomes; it’s African American babies.
Tiara Johnson Nurse Manager, UC San Diego Medical Center
Children’s Mental Health A Growing Specialty Mental health has moved from being a hidden issue to being central to pediatric nursing. We now talk about how physical disorders may affect cognitive functioning. We try to make sure that families are aware if their child presents in a way that concerns them, so we can identify issues early on and get the child the help they need. We look at how children’s social surroundings impact on their mental framework. We need to teach our young people how to care for themselves, how not to get involved with things that will alter their cognitive function. We have begun to tackle these issues head on.
Shelley Burke Assistant Clinical Professor, Sue & Bill Gross School of Nursing
Preterm Birth Rates Need to Fall No one wants their baby to have to start life in the NICU and it is wonderful that so many preterm neonates’ lives can now be saved. But to improve the long-term health outcomes of babies, and to save money that is needed in all areas of care, preterm birth is an area that we truly need to improve. A high rate of preterm birth ends up being a community cost and everyone benefits if we are able to bring that rate down.
Leanne Burke Assistant Clinical Professor and Director of Teaching, Excellence and Innovation, Sue & Bill Gross School of Nursing
