By dailyinvention, via Flickr.
While I agree with Diana Mason that Jackie, the nurse played by Edie Falco on Showtime’s new series, has some admirable qualities, some of her actions caused me to cringe: falsifying an organ donor card; snorting pain medication; cavorting with a coworker while on duty; and yes, flushing the ear of an abusive creep down the toilet (okay, part of me agreed with her—doesn’t the Bible say “an eye for an eye”? Couldn’t that apply here?). Read the rest of this entry ?
Despite a lofty reputation and purported commitment to universal coverage, AMA has fought almost every major effort at health care reform of the past 70 years. The group’s reputation on this matter is so notorious that historians pinpoint it with creating the ominous sounding phrase “socialized medicine” in the early decades of the 1900s.
In keeping with its long history of successfully opposing health care reform, the American Medical Association (AMA) is, surprise, doing it again. Anticipating the challenge presented by the lobbying clout of the AMA, President Obama will be taking the unusual step of directly addressing the organization’s annual meeting next week.
For a more constructive approach than the AMA’s to the reform process, check out a recent AJN editorial on some nurse-led solutions to improving care and reducing costs that should be part of any reform plan: “nurses can help to build the infrastructure we’ll need if we’re to shift from an emphasis on acute care to one on health promotion, chronic care management, and primary care . . . . “
Jacob Molyneux, senior editor
Nursing Times reports today that a nurse in Scotland has contracted the H1N1 virus from a patient. As the World Health Organization (WHO) meets this morning to almost certainly upgrade the virus to a phase 6 pandemic—perhaps reflecting not so much its severity thus far as its rapid spread around the globe—here’s a useful table succinctly describing the phases of a pandemic. And here’s an interesting take on how traditional scientific publishing has (at least in this case) adapted itself to a more open, rapid-response model to keep up with the spread of the virus.
When Loretto Klug, coordinator of the parish nurse program at Trinity Evangelical Lutheran Church in the historic hamlet of Freistadt in Mequon, checks someone’s blood pressure, she’s also taking their spiritual temperature.
That’s from a story about parish nurses working in the U.S. There are more nurses doing this than we’d known. Here’s another excerpt:
Parish nurses are registered nurses who volunteer or are paid by the congregations they serve. Some are paid by health care providers such as Aurora Health Care and ProHealth Care in Waukesha.
They typically conduct blood pressure and other health screenings, help people manage their medications, organize health fairs, visit shut-ins, train volunteers and make referrals. They can also sometimes help people deal with billing and insurance issues.
They also spend time praying with patients and sometimes engage in grief counseling. Migdal even administers Communion, she said.
It’s part of their holistic approach to congregants’ health needs, advocates say.
Religion, spirituality, faith, the mystical: all of these come up from time to time in submissions to AJN and in letters to the editor about various topics both controversial and not-so-controversial.
There are many religions and many angles on spirituality—which isn’t, of course, always the same thing as religion or belief—and many ways of thinking about nursing as a vocation, a profession, a paycheck, and so on. What role does spirituality or religion play in your life as a nurse? How does it inform your practice or help you make meaning out of what you do? Does it have a place in serious discussions of nursing as an evidence-based profession deserving of equal respect to medicine as practiced by physicians—or should it be kept out of sight and seen as a strictly private matter?
Jacob Molyneux, AJN senior editor
Photo by HeavyWeightGeek / Gavin Brogan, via Flickr
By now, most people are aware of the basic formula for maintaining a healthy weight: eating low calorie, nutritious food and exercising regularly. But obesity continues to be a major health issue worldwide, and it seems clear by now that there’s more than a knowledge deficit at the root of the problem. That’s why when I worked in primary care I was always frustrated by orders to give patients a handout on low-fat diets (and two minutes of explanation) and send them on their way. Once, a patient came in with back pain; she’d fallen out of a chair that broke when she sat on it. While her eyes glazed over, I spent a few minutes going over the diet the doctor ordered for her. At the end of this painfully futile exchange I asked her if she had any questions. She responded, “Have you ever thought of cutting your hair short?” Something tells me she didn’t run right out to buy vegetables and join a gym. Read the rest of this entry ?
Today Showtime launches Nurse Jackie, its new series starting Edie Falco. (Click the video above to watch the first episode.) The publicity people at Showtime saw my initial post on the trailer, so they sent me the first six episodes to watch. (Don’t worry, nothing I write here should spoil any major plot point in the coming episodes.)
This is already a controversial series. Postings on a nurses’ listserv indicate that many nurses who have watched the trailer or first episode aren’t thrilled with nurse Jackie Peyton. She’s addicted to pain medication that she obtains from the hospital pharmacist with whom she is having an affair. Although she’s smart and a fierce advocate for patients, she often goes beyond the bounds of appropriate professional conduct, as when she forges the signature of a dead bicycle messenger to authorize donation of his organs. (The disregard for official procedures and rules shown by Clint Eastwood’s Dirty Harry character came to mind when Jackie flushed down the toilet an ear that a prostitute had cut off the john who’d stabbed her.) Read the rest of this entry ?
From June through August 2008, photographer Eileen Hohmuth-Lemonick and I traveled throughout Malawi in southeastern Africa, documenting the everyday life of its nurses. For years, I had written tightly focused articles on advances in the treatment of asthma, diabetes, and other diseases and on important issues like the nursing shortage. But when I was given a Nieman Fellowship for Global Health Reporting at Harvard University, I decided to look at a larger theme: how health systems affect the way health care is delivered. I decided to focus on nurses. I chose Malawi because in recent years its health system had nearly collapsed. Nurses are the strong connective tissue that holds Malawi’s health programs together. I also hoped to study innovative efforts to stop the exodus of nurses from this tiny African country.
That’s former Time magazine health journalist and current blogger Christine Gorman, who wrote the text for “At Work with Malawi’s Nurses,” a photo-essay in the June issue of AJN (make sure to click through to the PDF, found under “Article Tools,” since the images are displayed more nicely in that version).
And click the image to the left for still more photos we didn’t have room for in the printed version of the article.
Blood Bubbles by frostnova, via Flickr.
I was really happy when I saw that a manuscript about pulse oximetry had been submitted to AJN. Pulse oximeters are everywhere in the health care environment, in both inpatient and outpatient settings, but—as a literature review published in the November 1 2006 issue of Australian Critical Care determined (click here for the abstract)—many clinicians don’t understand how they work. For example, a colleague told me that, one night when she was working, a physician wrote orders to replace continuous monitoring with once-per-shift monitoring for a patient whose condition had improved. She removed the probe from the patient and unplugged the machine, but kept it at the patient’s bedside. The patient care technician working that night documented the patient’s oxygen saturation level as 98% every hour from midnight to the end of the shift at 7 a.m., even though the patient was not hooked up to the oximeter. (The technician was terminated because of this). Read the rest of this entry ?
Photo from Planned Parenthood's candlelight vigil for Dr. George Tiller on Tuesday night. From KOMU News, via Flickr.
Before I earned my degree in nursing, I worked as a medical assistant at the Bill Baird Abortion Clinic in Hempstead, Long Island, which is believed to be the first abortion clinic in the United States. We used to take turns driving to LaGuardia Airport to pick up out-of-state women who came to New York City to access safe and legal services—something they couldn’t get back home in their own states. We served women of all ages and from all backgrounds. I counseled women and assisted during procedures.
It was also where the first arson attack against a clinic took place, on February 15, 1979, four years after Roe vs. Wade. Fifty people, over half of them patients, were inside at the time. Read the rest of this entry ?
By DeclanTM, via Flickr.
The most recent “Change of Shift,” a regular nursing blogosphere roundup (“the carnival dedicated to nurses and nursing”), is up over at Code Blog. We appreciate the mention of our recent post about virtual nurses in a virtual ICU.
How can we have health care reform without first controlling costs? In this week’s New Yorker, Atul Gawande undertakes a fascinating and in-depth comparison of the very different health care approaches of two American towns. Leave your preconceptions at the door.
Speaking of quality control, here’s Health News Review’s analysis of a recent story in the Washington Post about screening and treatment of major depressive disorder in teens (the story gets a 4 out of a possible 10).
And, for those of you in the mood, here’s one nurse’s blunt message to new interns. A brief excerpt:
I worked as a neurosurgical nurse many years ago at a teaching hospital in the Midwest, and twice a year a new crop of interns descended upon our unit. It was the best show in town. The spectacle began with the chief of neurosurgery, Dr. Holier Than Thou, strutting on to the unit with his entourage marching behind him.
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