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Anxiety Apps: New Fad or Worth the Download?

April 16, 2014

photo3By Amy M. Collins, editor

Today there’s an app for everything. There are find-your-keys apps, map-the-stars apps, even an app to help you hone your stapling skills. And apps exist to help patients with every kind of health care need, from managing diabetes to prenatal care. Usually, in an attempt to keep my smartphone use to a minimum, I avoid jumping on the trendy app bandwagon. But recently I came across an article touting an app to reduce anxiety. As a long-term, mostly recovered sufferer of chronic anxiety and panic, this article piqued my interest (and my skepticism).

While certainly not the first app developed to reduce stress, this particular app—called Personal Zen—has been tested by researchers who found that participants with relatively high scores on an anxiety survey showed less nervous behavior after using the app than those in a placebo group, according to a study published in Clinical Psychological Science. Developed by psychologist Tracy Dennis, a professor at Hunter College in New York City (and, it should probably be noted, one of the study’s lead authors), the app incorporates the concept of cognitive bias modification to get the user to shift their focus from a threatening stimulus to a nonthreatening one. More studies are needed to see if such an app would have the same success in those with clinically diagnosed anxiety.

And there are literally hundreds of other apps catering to those with anxiety (click here for a Healthline article on the 17 “best” antianxiety apps; and here are more from Google Play).

Is it really that easy? If only antianxiety apps were available when I was first diagnosed over a decade ago. Back in that particular Stone Age, I had limited choices: antianxiety meds, talk therapy, alternative methods, or a combination of these options. I chose therapy and alternative methods and embarked on a 10-year quest to control the disorder instead of vice versa. I read books, employed relaxation techniques, joined groups, and challenged myself to face situations that caused anxiety. Employing these tactics eventually brought me to a place where I could live relatively anxiety free without medication. Read the rest of this entry »

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Nursing Students and Then Some – In Opryland, Revisiting AJN’s Long Connection With NSNA

April 14, 2014

Revisiting AJN’s long connection with this vibrant student nursing association. 

By Maureen Shawn Kennedy, MA, RN, editor-in-chief

Opryland critters

Opryland critters

I’ve said it a number of times over the years, most recently in my editorial in the April issue of AJN: the National Student Nurses Association (NSNA) is a vibrant organization and produces one of the most well-organized annual meetings in nursing. This year, it broke attendance records, drawing approximately 3,200 students and faculty advisors to the Opryland Hotel in Nashville, where I spent part of last week.*

Supporting NSNA since its founding. The American Journal of Nursing has been a supporter and and sponsor of the NSNA since the organization began in 1952. The NSNA offices used to be part of the AJN offices at one time, and before NSNA had its own publication (Imprint), AJN published “The Student Pages.” We sponsor Project InTouch, an award given to the student who recruits the most new members for the organization. This year, winner Joanna Laufer from East Carolina University, Greenville, North Carolina, recruited 130 new members; overall, this initiative brought in over 1,600 new members this year. Impressive.

Impressive, and sharp dressers too! The students I met—mostly junior and senior nursing students—were also impressive. They were enthusiastic, eager to learn, and professional. I have to say this group as a whole was better dressed than many attendees I’ve seen at other nursing conferences—they clearly got the message about what business casual meant; I rarely saw anyone in jeans.

The students’ major concern was of course, finding a job in this tight market. And there were few recruiters other than the military services among the couple of hundred exhibitors—most were schools of nursing and companies with educational products for passing the licensing exam. Many speakers reinforced the message that the tradition of working in a hospital for a year before working in other settings is not necessary (and likely never was), and students seemed a bit relieved to hear that. But more jobs will be opening in primary care settings and preventive care services; senior care centers and long term care will grow along with the aging population, so jobs will be there, too. And while it might be tough now to get a job in a hospital, the market will be very different in a few years as older nurses retire. Read the rest of this entry »

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What Advice Would You Give a New Nursing Student? Our Readers Respond…

April 9, 2014

KarenRoushBy Karen Roush, MSN, RN, FNP-C, AJN clinical managing editor

My daughter Kim is starting nursing school next month, so last week I asked AJN’s Facebook followers for the best piece of advice I could give her. The response was overwhelming: over 600 people offered wisdom, encouragement, and tips for success. I went through and read them all and the following is an attempt to synthesize the advice.

Of course, with so many responses, there were many valuable pieces of advice I had to leave out, from the practical to the profound, such as:

sit in the front of class, stick to your principles, invest in good shoes, choose clinicals that push you out of your comfort zone, be early for everything, celebrate the small victories, get a really good stethoscope up front, believe in yourself, pick the hardest patient you can at clinical, audiorecord the lectures, be truthful and committed to your work, eat healthy, get to know your instructors, coffee and chocolate!

And finally: look into the eyes of your patients and be sure they know you care. Every patient, every time.

(Oh, and not to leave out the lighthearted—Don’t hold your nose in clinicals. The teachers frown on that.)

Below are five areas of advice that stood out:

1) “Take a good picture of your friends and family and put it on your desk, because that’s all you’ll be seeing of them for the next two years.” There were many variations on the idea that nursing school “takes 100% dedication.” You need to warn your family and friends that they won’t be seeing you for a while, get rid of your TV, sleep when you can, learn good time management, and be prepared to spend Saturday nights with your books . . .

2) “Study, study, study, and study some more.” Respect the quantity and degree of difficulty of the material you will have to learn. There were a lot of ideas about how to optimize your studying—chief among them was to get in a study group and to study NCLEX questions from the beginning. Others were to read ahead, not procrastinate, use flashcards, attend practice and review sessions, and have a study partner or buddy system. Having a study buddy, though, is only a small part of the importance of friendships with your fellow students . . . Read the rest of this entry »

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The Blame Game

April 7, 2014

By Jacob Molyneux, senior editor

TheBlameGameIllustrationThe Reflections essay in the April issue of AJN is called “The Blame Game.” It’s by a nurse who finds herself visiting a family member in the hospital during her shift break at the same hospital. In her distress, she gets little relief or reassurance from the harshly judgmental nurse she encounters.

The vividly told episode raises the question: can the act of casting judgment on another person diminish our ability to see these people as complete human beings, whatever their failings? And also this question: what is the proper attitude of nurses toward their patients?

Please give it a read and see what you think. Is this nurse’s attitude an exception, or more common than it should be, as the author suggests? Here’s a brief quote from near the end:

There seems to be a dangerous epidemic of clinicians blaming patients for their health issues. As a nursing student, I saw more and more of this attitude. The health care profession seems to have evolved a culture of accusation and attack against patients, a group we should be empowering and protecting.

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Recent Nurse Blog Posts of Interest, Inhaled Insulin, a Note on Top Blogs Lists

April 4, 2014

By Jacob Molyneux, AJN senior editor/blog editor

Here you will find some links to nursing blog posts, a look at this week’s Affordable Care Act health exchange enrollment numbers, and a couple of items of interest about new treatments or studies, plus a note on blogs that award other blogs badges. A grab bag, so bear with me if you think it’s worth the time…and remember, there’s no shame in jumping ship mid-post.

crocus shoots, early spring, I think/ via Wikimedia Commons

crocus shoots, early spring, I think/ via Wikimedia Commons

At the nursing blogs:

RehabRN has a post about a friend who was bullied by a nurse of much higher authority in the same hospital. Such stories, if true, are always upsetting. What can you do but take it when the power differential is so great?

At the INQRI blog (I’m not going to tell you what the initials stand for except that it has something to with quality, research, and nursing), there’s a post about why stroke survivors need a team approach to palliative care.

Megen Duffy (aka Not Nurse Ratched) has a really very good post at a site she sometimes blogs for. I already shared it via a tweet yesterday, but it deserves more. It’s called “Nursing Will Change You.”

At Infusion Nurse Blog, there’s a post addressing IV solution shortages (now happening on top of shortages of some common and necessary drugs due to a variety of reasons). It gives some practical steps clinicians and organizations can take to conserve and is definitely worth a quick look.

A sweet little post called “Nursing Sisters” is at Adrienne, {Student} Nurse. It’s about how nurses help each other out, starting right from the beginning in nursing school.

Read the rest of this entry »

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The Power of Imagination: Helping Kids with Sickle Cell Disease to Cope with Pain

April 2, 2014

By Sylvia Foley, AJN senior editor

Many people with sickle cell disease suffer from both acute and chronic pain, which can be severe. Although the exact mechanism isn’t known, the pain is believed to result when sickled erythrocytes occlude the vascular beds, causing tissue ischemia. Such pain, which often begins in early childhood, arises unpredictably. Although some pain crises may require ED visits, hos­pitalization, opioid treatment, or a combination of these, most are managed at home. Yet little is known about at-home pain management in people with sickle cell disease, especially children.

Table 2. Changes in Self-Efficacy, Imaging Ability, and Pain Perception in School-Age Children After Guided Imagery Training

Table 2. Changes in Self-Efficacy, Imaging Ability, and Pain Perception in School-Age Children After Guided Imagery Training

Cognitive behavioral therapy (CBT) has shown promise in helping patients with other chronic illnesses to cope with pain. Cassandra Elaine Dobson and Mary Woods Byrne decided to test guided imagery, a form of CBT, among children enrolled at one sickle cell treatment clinic in New York City. They report on their findings in this month’s original research CE, “Using Guided Imagery to Manage Pain in Young Children with Sickle Cell Disease.” The abstract below offers a quick overview; if you click the image above, you’ll see an enlarged view of one table showing key results.

Objectives: The purposes of this study were to test the effects of guided imagery training on school-age children who had been diagnosed with sickle cell disease, and to describe changes in pain perception, analgesic use, self-efficacy, and imaging ability from the month before to the month after training.
Methods: A quasi-experimental interrupted time-series design was used with a purposive sample of 20 children ages six to 11 years enrolled from one sickle cell disease clinic, where they had been treated for at least one year. Children completed pain diaries daily for two months, and investigators measured baseline and end-of-treatment imaging ability and self-efficacy.
Results: After training in the use of guided imagery, participants reported significant increases in self-efficacy and reductions in pain intensity, and use of analgesics decreased as well.
Conclusions: Guided imagery is an effective technique for managing and limiting sickle cell disease–related pain in a pediatric population.

The technique was easily taught in training sessions lasting 15 to 45 minutes, with no child needing more than one session. The authors concluded that “the use of guided imagery in this population assumes that a child’s imagination has the potential to affect health, and our findings support that assumption.” Because this was a small study, they urged further large-scale clinical trials.

To learn more, read the article, which is free online. As always—and especially if you have experience caring for children with sickle cell disease—we welcome your comments.

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AJN’s April Issue: Sickle Cell Anemia, Telehealth, Systematic Reviews, FOAMed, More

March 28, 2014

AJN0414.Cover.OnlineAJN‘s April issue is now available on our Web site. Here’s a selection of what not to miss, including two continuing education (CE) articles that you can access for free.

Coping with pain in sickle cell anemia. Our April cover features a painting of red flowers in a vase. But on closer inspection, you might notice that the flowers are actually red blood cells, painted by a young girl who suffers from sickle cell anemia. Afflicting about 90,000 to 100,000 people in the United States, sickle cell disease often causes acute and chronic pain syndromes described as being on par with cancer-related pain. Cognitive behavioral therapies, such as the use of guided imagery, have shown promise in changing pain perception and coping patterns in people with chronic illnesses. April’s original research CE article, “Using Guided Imagery to Manage Pain in Young Children with Sickle Cell Disease,” suggests that this technique can be effective for managing pain in school-age children with the disease.

Implementing advances in telehealth. New technologies such as remote monitoring and videoconferencing often emerge before a facility is ready to efficiently integrate them. Sometimes referred to as disruptive innovations, these technologies, while convenient and easy to use, may not be readily accepted. “Telehealth: A Case Study in Disruptive Innovation” discusses the many applications of telehealth, a means of delivering care that is likely to be a part of every nurse’s skill set. If you’re reading AJN on your iPad, you can listen to a podcast interview with the author by tapping on the podcast icon on the first page. The podcast is also available on our Web site.

New installment on systematic reviews. Last month, we debuted our new series from the Joanna Briggs Institute on the systematic review. This second installment, “Developing the Review Question and Inclusion Criteria,” provides an overview of the first steps taken when conducting such a review, starting with forming the perfect review question.

#FOAMed. The April iNurse column, “Have You FOAMed?” delves into the new and still evolving social media concept called FOAM, or Free Open Access Meducation. FOAM is an umbrella concept that refers to online media that students and professionals can use to educate themselves and to share and discuss new knowledge and ideas. It spans many social media platforms and is a fast, free way to keep up with the latest in medical knowledge. Read the rest of this entry »

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