Hospital walls don’t confine this nurse scholar from applying her hands-on research findings gained from healing experiences in the adult populations of critical care units, long-term care facilities and community groups focused on the needs of aging, marginalized, vulnerable and underserved populations.

Tamara Adonis-Rizzo, MSN, APRN, GNP-BC, and current PhD candidate was born in Haiti and survived yellow fever, thanks to courageous nurses who helped her fight and beat the odds. She credits these nurses with the legacy of planting the seed for her to embark on a lifetime commitment to nursing care and scholarship. Following that initial triumph over disease she enjoyed her early youth in Haiti growing up in a multigenerational family and has long admired the tenacity and healthy aging of both her grandmothers. Her family moved to New Jersey when she was a pre-teen. After earning her BSN from Seton Hall University and starting her career in nursing with a focus in pulmonology and critical care; she moved to sunnier skies in Florida. Here she received her MSN Gerontology Nurse Practitioner at Florida Atlantic University (FAU), is a board-certified gerontology nurse practitioner and a current PhD candidate.
 
Throughout her career, in addition to her on-going patient load as a nurse practitioner she has also been an innovative advocate for promoting wellness and healthy living among older adults and minorities adding culturally-appropriate education and tools to the healing process.
 
For example, when the COVID-19 crisis hit, she was able to pair her work and masters research experiences on the annual flu vaccine with knowledgeable community and church affiliated connections to battle the pandemic obliteration of social interactions among seniors. This isolation was compounded by a technology gap, so she partnered with the FAU Memory and Wellness Center to support seniors by providing access to an Uber line so older members can stay connected via telephone during the pandemic. A support group was led by the wellness center Nurse Practitioners and group leader.
 
She relied on her working ties and outreach with the Black Nurse Practitioners of Palm Beach County Association, the Haitian-American Nurse Association, the Genesis Community Clinic Health Center and Caridad Center, along with the Palm Beach County Commission. Together plans were quickly implemented to coordinate registrations and administer vaccines for those unable to access technology to sign up for appointments.
 
“I used my connections as a vehicle to increase access to COVID testing and vaccinations in vulnerable older populations,” Rizzo said. “We knew who could not maneuver through the technological pathways for registration and made arrangements to speed up the process for them.”
 
She also worked to replace cancelled on-site fitness and healthy aging support groups with a university sponsored Memory Café, a regular weekly interaction of 25-30 participants over phone lines to connect and inspire Haitian older adults to maintain a focus on preventive health and maintenance. Additionally, an awareness of older adults who were more savvy with technology allowed her to create a train-the-trainer program to empower older adults to connect with each other and avoid or at least alert health professionals of some mental or physical health issues that loneliness can cause.
 
A member of the Haitian Catholic Church since 1995, she describes her involvement with the Haitian-American older adult population serving as the health ministry coordinator since 2006, providing a pathway to outreach, health programs and health mission trips to the Dominican Republic servicing Haitian refugees there.
 
According to Rizzo, aging does not necessarily need to be accented by debilitating illness and dementia. Older adults are resilient and can thrive with the benefits of a wholistic approach to health. One serious health event can lead to a domino effect in wellness, she explained.
 
“My model of nursing care is to apply my knowledge of the clinical, social, cultural, environmental and personal aspects of healing and prevention… not just providing responsive catch-up nursing care to treat disease symptoms,” she explained.
 
A published author, advanced clinician, health advocate, educator, mentor and preceptor, Rizzo is also proud of being a mom of three thriving young adult sons. She lives and breathes her mission to lead and support efforts to improve the quality of life in aging minority populations.


With so many groundbreaking cyber-attacks threatening healthcare organizations, many are upgrading their cyber protection. Unfortunately, what most don’t realize is that the threat isn’t always from within—the majority of cyber hacks are coming through third-party vendors.

“Think about all of the third-party vendors you have: billing companies, laboratories, numerous medical supply companies … the list goes on,” said Medical Malpractice and Workers’ Compensation Specialist Tom Murphy at Danna-Gracey, the largest independent medical malpractice insurance agency in Florida. “In this age of information technology, we are all interconnected, and since a lot of companies share important medical and patient information, that’s where they run into trouble.”
 
In fact, Cyber Risk Underwriters, which provides technology-driven cyber risk insurance solutions to clients including Danna-Gracey, recently released a study that estimates that 75 percent of its healthcare client’s cyber issues were the direct result of their third-party vendors being hacked.
 
“This is why we’re seeing larger healthcare organizations and hospital systems taking a closer look at vendor contracts and attempting to determine their vulnerabilities,” said Murphy. “These types of breaches can result in serious financial loss and reputational loss, as well as fines and penalties for breaching HIPAA and HITECH (Health Information Technology for Economic and Clinical Health Act) guidelines. That’s why some healthcare organizations are mandating that their third-party vendor provide proof of their own cyber insurance or complete a cyber-security certification.”
 
To earn this certification, a company is analyzed by a reputable cyber security organization that assesses its systems to determine the level of accessibility and vulnerability. It then provides recommendations or assists the company in putting protective processes in place.
 
“In this day and age, there’s no way to be 100 percent protected because cyber security is a moving target; criminals find new ways every day to breach cyber systems,” said Murphy, “It’s a constant battle to keep up.”
 
Without taking these steps, however, companies can find themselves in a world of trouble.
 
In 2019, for example, medical testing giants Labcorp and Quest Diagnostics were both using American Medical Collection Agency (AMCA) as a third-party vendor. When that company was breached, more than 19.4 million patients’ information was determined to have been exposed over the course of a year.
 
“Quest and Labcorp had to step in and get their insurance and public relations firms involved, and as of today, they are still dealing with financial ramifications, as well as huge damage to their reputations,” said Murphy. “They are also facing a number of class-action lawsuits in federal courts and in multiple states.”
 
He added that while the companies can likely withstand these financial issues because they had the proper insurance coverage, they now have to worry about ongoing government investigations that could result in penalties and fines for noncompliance with HIPAA and HITECH.
 
“AMCA filed for Chapter 11; what was once a strong financial company is out of business because of just one breach,” he added.
 
Know Your Vendors
Murphy recommends taking the advice of cyber risk analyst Katell Thielemann, who lists three things that companies can do to help protect themselves from these types of third-party issues.
 
“First, know all of the industry regulations applicable to your organization; do your homework and understand what these regulations—like HIPAA and HITECH—are,” said Murphy, adding that other industries will have different guidelines and regulations.
 
“Second, assess the security and risk management profile for all of your vendors; before you contract with them, find out what kind of security and risk management they have in place to protect themselves and your vulnerable information.”
 
Lastly, healthcare companies should know what information needs to be protected. “What types of information do you both share? How are you going to protect it? This seems like common sense, but it often gets overlooked when signing contracts,” advised Murphy.
 
He adds that healthcare organizations are at even greater exposure with the changes brought on by the pandemic. “Simply by using remote services and telehealth, healthcare organizations have become greater targets,” he said. “Companies involved in the cyber world have confirmed seeing a large increase in attacks and exposure.”
 
Proactively making sure that medical and patient information is safe can help prevent long-term fallout.
 
“If a company has done everything they can do to follow HIPAA and HITECH; if they have done their due diligence, have the proper protocols and coverage, and make sure their third-party vendors have the proper protocols in place, then they are typically okay in terms of government fines and penalties if a breach occurs,” said Murphy.
 
“On the flip side, they will still have financial issues and reputational damage,” he added. “That’s why it’s important to work with a really robust cyber protection company; not only to get insurance in case a breach occurs, but to be proactive in preventing this exposure from happening.”


COVID-19 has drawn attention to many nursing trends throughout the nation, whether pre-existing, rising in priority, or brand new to our field. As leaders, we need to understand these issues and appropriately intervene so that our profession can emerge from the pandemic stronger than when it began.

The Knowledge Gap
In particular, the existing knowledge-complexity gap aptly described by the Advisory Board is widening. The chasm between the complex patient care needs and the nurses who possess the necessary knowledge and ability to provide such care is growing. Skilled baby boomer nurses are retiring sooner than originally anticipated as a result of COVID’s threat to their own health. Residency programs, mentorships, and newly-designed methods for preparing a novice nursing workforce are opportunities that must be embraced to mitigate the risk this dilemma poses to patient care.
 
The good news is we’re in a time that respect for nurses and the challenges they face has never been higher, with the personal risks that accompany patient care during a pandemic acknowledged by those both inside and outside the healthcare industry. Media has documented the emotional, spiritual, and physical toll the last 14 months have taken on caregivers who have shared their heart-wrenching experiences. The public has lauded nurses as heroes and physicians have recognized their co-workers as their own guardians, realizing more than ever how much they depend on them. The opportunity exists, much as it did for first responders after 9/11, to harness this respect and ensure we remain valued and able to recruit talent moving forward.
 
Embracing Innovation
Unlike the past, when nurses were often derisively called "masters of workarounds" when they solved process problems, innovation is applauded now. With the ever-present threat of infection spread, inventive solutions, like externalizing equipment lines to allow adjustments without causing unnecessary risk of viral exposure, nurses earn praise. Hospital leaders need to embrace and celebrate innovation if their teams are to continue meeting the challenges presented by increasingly complicated practice environments.
 
Technological advancements in patient management are occurring at a faster pace than before and nurses must adapt accordingly. Further, using the electronic medical record to trend patient responses, leveraging technological adjuncts for safety, and using mobile devices for access to best practices are more commonplace. This is an opportunity for nursing leaders to engage frontline staff in the selection and deployment of technology to maximize the benefits it can bring to patient care.
 
The Impact of Travelers
With the rising demand for nurses and more states joining the Nurse Licensure Compact, it is now easier for travel nurse agencies to persuade nurses to leave permanent positions and work for lucrative travel contracts. Monetary incentives play a bigger role than in the past, and newly deemed competent nurses are prime targets for the travel nurse recruiters. Complicating matters for healthcare systems, hospitals are having to hire expensive travelers to fill the very gaps created by this movement. To stem the tide, we must be more creative about retaining talent, whether it be through internal programs that mirror travel contracts, extra shift incentives, hazard pay, or some combination of all to lessen the gravity of this trend.
 
Taking Care of Our Own
Even before COVID-19, caregiver resilience was a focus in healthcare in order to survive the changing market. Now, it’s a top priority because of the toll personal and professional stress has taken on those charged with providing care during a prolonged crisis. Institutions need to invest significant resources in mental health services for their nursing teams in order to mitigate the post-traumatic ramifications on the workforce.
 
Nurses are flexible, agile, and incredibly persistent. We need to leverage these attributes against the challenges we face today and in the future. It’s the only way our noble profession can maximize its impact on patient care and push past obstacles into the future of healthcare.


April 27, 2021 – When someone has cognitive symptoms not associated with normal aging, an evaluation at a memory disorder clinic and neuropsychological testing can help determine the cause. On May 4, the Alzheimer’s Association will host a deep dive into neuropsychological testing with its virtual program, “What if It Isn’t Alzheimer’s?” 
 
“While some mild changes in cognition are considered a normal part of the aging process, dementia is not,” noted Paula Cooper, Ph.D., a neuropsychologist at the Sarasota Memorial Hospital Memory Disorder Clinic and guest speaker for the event. “Normal age-related declines are subtle and mostly affect the speed of thinking and attentional control.”
 
Danielle Valery, program manager for the Sarasota Memorial Hospital Memory Disorder Clinic, will also be a featured speaker of the program, to be followed by Alzheimer’s Association Community Educator Fitzgerald Mason, who will speak on the 10 warning signs of Alzheimer’s disease.
 
Bernice Pelea, program manager for the Alzheimer’s Association, noted: “There is a common misconception that Alzheimer’s disease and memory loss as a result of aging are one and the same. In reality, not every case of memory loss is a symptom of Alzheimer’s disease. Neuropsychological testing can help those who are experiencing memory loss to identify the true culprit.”
“What if It Isn’t Alzheimer’s?” will begin at 11:30 a.m. EDT on Tuesday, May 4. Register by calling the Alzheimer’s Association 24/7 Helpline at (800) 272-3900 or by visiting 
http://bit.ly/AlzWhatIf. 
 
 
Alzheimer’s Association®
The Alzheimer’s Association is a worldwide voluntary health organization dedicated to Alzheimer’s care, support and research. Our mission is to lead the way to end Alzheimer’s and all other dementia – by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer’s and all other dementia. Visit alz.org or call (800) 272-3900.
 


April 27, 2021 – On Friday, April 23, U.S. Representative Lois Frankel (F-21), her District Chief of Staff Felicia Goldstein, JD, and Alina Alonso, MD, director, Florida Department of Health in Palm Beach County joined local rheumatologists and members of the international non-profit organization CreakyJoints to celebrate the reopening of the now named John Whelton Arthur Virshup CreakyJoints South Florida Arthritis Clinics. 
 
Also at the event were Dr. John Whelton’s family and Dr. Arthur Vishup and his family, who founded the clinic in 1975 after recognizing the vital need for reliable access to professional medical services for uninsured patients with rheumatologic diseases. For decades, it was maintained locally through a generous bequest by local resident Mary Greissler, who donated money in her will for a building. 
 
As additional Florida-based rheumatologists donated their time to support more patients, the clinic expanded from one location to four and now sees people living with rheumatic diseases monthly in private practice locations in Boca Raton, Boynton Beach, Stuart, and West Palm Beach, Florida. Identical to services provided to insured patients, clinic patients receive consistent and high-quality care, and have access to laboratory and imaging services subsidized by local supporters. Care is available in both English and Spanish, reflecting the needs of the local community, and coordinated by CreakyJoints Patient Care Coordinator Barbara Boyd-Floering.
 
Last year the Arthritis Foundation experienced financial difficulties, laid off staff nationwide and could no longer afford to fund the clinic. CreakyJoints, a digital arthritis community and part of the Global Healthy Living Foundation, sustained clinic operations by immediately providing a financial and administrative lifeline. 
 
“The clinic is now financially secure,” said GHLF Executive Director and Co-Founder Louis Tharp.
 
At Friday afternoon’s rededication ceremony, Michael C. Schweitz, MD, a longtime volunteer rheumatologist with the John Whelton Arthur Virshup CreakyJoints South Florida Arthritis Clinics, past president of the Coalition of State Rheumatology Organizations (CSRO), and past president of the Florida Society of Rheumatology, spoke about how the clinic serves patients and his relief that the clinic’s future was ensured. Also in attendance was Dr. Joseph Forstot, who started the Boca Raton clinic with Dr. Ira Pardo. Dr. Catherine Garcia, Dr. Amiel Tokayer, Dr. Michael Ross, Dr. Darrell Fiske, and Dr. Juan Maya, all volunteer doctors for the clinic, Carmen Amodie, who  was instrumental in opening the Martin clinic, and Cheryl Scott, a longtime volunteer nurse for West Palm Beach clinic also attended.   
 
W. Benjamin Nowell, PhD., Director of Patient-Centered Outreach at CreakyJoints, traveled to Florida for the event. He said, “CreakyJoints didn’t hesitate to support the John Whelton Arthur Virshup CreakyJoints South Florida Arthritis Clinics because we understand how important it is for people living with arthritis and other rheumatic conditions to have long-lasting relationships with their doctors so that they can manage their condition over a lifetime. We congratulate all the doctors, their supporting staff, and local partners for sustaining the clinic over decades and serving thousands of patients. We further thank Congresswoman Frankel and Dr. Alonso for attending the event and lending their support to the clinic’s mission.”
 
Although she could not attend, Kelly Skidmore, a Democrat representing the clinics in Florida’s 90th District in the Florida House of Representatives, and a long-time friend and supporter, thanked the physicians, staff and CreakyJoints for their service to the community.
 
In addition to providing medical care, the volunteer rheumatologists will educate their clinic patients about CreakyJoints’ comprehensive free resources, such as downloadable, disease-specific patient guidelines, ArthritisPower (a disease tracker and research registry), and other educational opportunities available on their websites and social media platforms in both English and Spanish.