Archive for May, 2009

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New Nurses Blogging: The Dedicated, the Feisty, the Sleep-Deprived

May 8, 2009
Hospital by boliston / Adrian Boliston, via Flickr.

Hospital by boliston / Adrian Boliston, via Flickr.

When I went looking for blogs by student nurses recently, I found plenty—but most appeared to be deserted, as if their authors had literally packed up and moved away after graduation. That’s understandable—and kind of a shame. Things can get interesting fast when one finds oneself suddenly working with real people in an ED or an ICU. Lucky for us, a few newly minted nurses are blogging on just that. (To comply with HIPAA regulations, most bloggers report that they alter patient details and scenarios.)

At Call Bells Make Me Nervous, Maha, “a shiny new nurse” (degree unspecified), blogs Read the rest of this entry ?

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School Nurses, H1N1, Understaffing, and Public Safety

May 8, 2009

We’ve posted here, here, and here in recent days about the importance of school nurses during the H1N1 outbreak.

Now here’s strong testimony before the U.S. House Committee on Education and Labor from the California State Superintendent of Public Instruction on why school nurses were crucial during the H1N1 outbreak and why understaffing issues must be addressed for the sake of public health.

“At last count, there are approximately 2,844 nurses who serve California’s 6.3 million public school students. That translates to a ratio of 2,227 students to every one school nurse, the largest student-to-nurse ratio in the country. This in no way, shape or form provides effective healthcare for the increasing numbers of students with complex chronic and immediate health needs that require daily care on our school campuses. If we had more school nurses on our campuses, perhaps they could have played an even greater role in early detection and prevention efforts.”

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National School Nurse Day—The Timing Couldn’t Be Better

May 6, 2009
Mary Pappas, BSN, RN, school nurse at St. Francis Preparatory School in NYC, told AJN, "School nurses have been e-mailing me from around the country," since she helped to identify the first H1N1 cases. Photos courtesy of Michael Graziano.

Mary Pappas, BSN, RN, school nurse at St. Francis Preparatory School in NYC, told AJN, "School nurses have been e-mailing me from around the country," since she helped to identify the first H1N1 cases. Photos courtesy of Michael Graziano.

As nurses nationwide celebrate National School Nurse Day AJN decided to check back in with Mary Pappas after our discussion with her last week. She’s the New York City Catholic school nurse who on April 23 alerted public health officials to what would be identified as the first U.S. cases of influenza A (H1N1)—swine flu. img_4700

Students have returned to St. Francis Preparatory School, and things are “calming down,” she said. “We’re still busy because we have to do a screening process. It’s busy work, but no one’s sick.” She has been working closely with the New York State Department of Health.

Yesterday the Centers for Disease Control and Prevention (CDC) said that, because the U.S. cases seen so far have been mild, “School closure is not advised for a suspected or confirmed case of novel influenza A (H1N1).” It seems an appropriate moment to acknowledge the work that Pappas and the 45,000 school nurses are doing on the front lines of assessment nationwide. AJN will continue to follow the work of school nurses in coming weeks and months.—Joy Jacobson, AJN managing editor

(For a more recent post about pandemics, understaffing, and school nurses, click here.)

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Will Sebelius ‘Walk the Talk’ on Nurses and Health Care Reform?

May 6, 2009
HSS Secretary Kathleen Sebelius. Photo by National Governors Association, via Flickr.

HSS Secretary Kathleen Sebelius. Photo by National Governors Association, via Flickr.

Reportedly, in a speech yesterday to nurses with the American Federation of State, County and Municipal Employees (AFSCME), brand new Department of Health and Human Services (HHS) Secretary Kathleen Sebelius told the group that if the Obama administration is to “make health reform a reality, we need nurses at the forefront of the effort.”

Sounds good, and it’s on point with Obama’s messages to nurses during his campaign.

So far, the Obama team has been consistent with its positions on health care reform. But as we learned from the Clintons’ efforts, talk doesn’t always translate into reality. Dare we hope that this time—with nurse Mary Wakefield as administrator of the Health Resources and Services Administration (HRSA); a Democratic-controlled Congress; data like we’ve never had before linking nurses to quality, cost-effective health outcomes; and a population at the end of its rope—maybe, just maybe Congress will get it right? Or will the powerful insurance and medical lobbyists prevail?—Shawn Kennedy, AJN editorial director

(AJN editor-in-chief Diana Mason adds this comment: Sebelius knows that nurses are key to reforming health care and reducing health care disparities. We have an infrastructure of childbirthing centers, community nursing centers, convenient care clinics, and other models of care that can be ramped up if Congress and states will remove barriers to full utilization, fair payment, and credentialling of nurses, including permitting them to head medical homes when necessary.)

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The Little Humiliations of National Nurses Week

May 6, 2009
By Stephen Cummings, via Flickr.

By Stephen Cummings, via Flickr.

“When is ‘Kid’s Day’?” That’s what I asked my mother on Mother’s Day one year, after she’d finished opening her gifts from the five of us. And—like many who’ve asked before—I was told, “Every day is Kid’s Day.” This led me to realize that people who have days or weeks dedicated to them must have it pretty bad the rest of the year. Professions with prestige and power don’t have a day or a week. So how can nurses be seen as equal professionals if we have Nurses Week? Read the rest of this entry ?

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“Maybe I Couldn’t Have Done That”: (Almost) Memories of Being a Nurse in Vietnam

May 5, 2009
Vietnam Women's Memorial, Washington, DC. Courtesy of Kay Schwebke.

Vietnam Women's Memorial, Washington, DC. Courtesy of Kay Schwebke.

I attended nursing school between 1967 and 1971, when the war in Vietnam was raging. I spent a good part of 1968 at the Manhattan Veterans Administration (VA) Hospital, where I did much of my medical–surgical clinical rotation. Two days a week, I provided care for injured soldiers who were my own age. In the evening, I watched newscasts filled with images of freshly wounded soldiers and napalmed villagers and dutifully listened to the nightly body count, feeling not much better when “we” had fewer than “them.” Read the rest of this entry ?

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Pediatricians Protect Turf in Medical Homes in Bid to Deny Nurse Practitioners Role in Care Coordination

May 4, 2009
Photo by faeryboots, via Flickr.

Photo by faeryboots, via Flickr.

The April issue of Pediatric News, the newspaper for pediatricians, has a front-page story on the official position of the American Academy of Pediatrics to oppose nurse practitioners (NPs) in independent practice. It doesn’t matter that in some areas of the country, the ONLY primary care provider may be an NP or a physician’s assistant (PA).

The National Association of Pediatric Nurse Practitioners (NAPNAP) has issued a statement that points out their dismay regarding this position by their physician colleagues, noting that there is abundant evidence documenting that pediatric NPs have clinical outcomes that are comparable to those of pediatricians and asserting that NAPNAP will continue to focus on reforming health care to ensure access to care for the nation’s children.

The issue is who will control and be paid for care coordination through medical homes. Physician groups have been insistent that only practices led by a physician should qualify as “medical homes.” This means that an NP or PA in a rural area who has physician backup through telemedicine must pretend that the physician “leads” the practice—and the physician will get the fee for the care coordination even if that coordination is done solely by the NP or PA. Sounds like a good way to reduce access to care coordination, drive up costs, and put frontline practitioners out of practice. Whose interests are being served?

Diana J. Mason, AJN editor-in-chief

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A Random Friday Sample of Feverish and Flu-Related Opinion

May 1, 2009

It’s been a busy week, with constant updates on the progress of the H1N1 infection (swine flu). Nothing sells a story like fear. How much of what we’re hearing is just media noise? Is the flu really changing most of our lives in any substantive way? Will it? Who’s afraid, and who’s not? Here’s a random sample of fact, speculation, and opinion we came across today.   

A rant: “All pigs are men: why we need to learn to manage infodemics, too…

From the Wall Street Journal Health Blog, an interesting angle on numbers and severity: “Why Does the Flu Seem More Severe in Mexico: Here’s a Clue.”

Curtis Brainard of the Columbia Journalism Review writes that “blogs have called upon mainstream media to investigate the potential role of large factory farms in breeding and spreading the virus” in Mexico.

A cranky reality check from the nursing trenches: “What kind of country of dummies have we become when the PRESIDENT has to go on TV and tell us to WASH OUR HANDS and COVER OUR MOUTHS when we cough?”

Lastly, some sensible thinking on personal preparedness from Christine Gorman at Global Health Report.

-Jacob Molyneux, AJN senior editor, and Joy Jacobson, AJN managing editor

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“Try Not To, As Often As You Can”: The Word Curmudgeon Waxes Acrimonious on Acronyms

May 1, 2009
“Doyle Alphabet,” by fdecomite, via Flickr.

“Doyle Alphabet,” by fdecomite, via Flickr.

A word curmudgeon would have nothing against which to curmudge if writers stopped coming up with newer and stranger ways to say things.

Take the acronym (or initialism, which looks just like an acronym but doesn’t make a pronounceable “word”: HPV is an initialism; HIPAA is an acronym). Use too many acronyms in your article and the introductory paragraphs become de facto glossaries, which the reader will have to return to repeatedly in order to decipher the paper.

At AJN our rule on acronyms is try not to, as often as you can. (Put another way, that’s use as few as you can get away with.) Read the rest of this entry ?

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