At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.”
(Read the whole column by Paul Krugman in the NY Times.)
Former Time magazine health care journalist Christine Gorman recently wrote the text for an AJN photo-essay about the nursing shortage in Malawi. Here’s what we posted about it a little while back, with links to the photos and article. Now CNN is running an excellent story by Gorman on the topic. Here’s the article—and click on the image at the left to go to the video.
Every morning at 7 a.m., I get up and watch the Today Show. Yesterday morning, I heard this: “a young woman, eight months pregnant . . . found murdered on Monday. Twenty-three-year-old Darlene Haynes was discovered in the closet of her Worcester, Massachusetts apartment—her fetus had been taken from her womb.” I immediately checked to see if the channel had somehow been changed—it certainly sounded like the beginning of an episode of Law and Order: SVU.
Nonfamily infant abductions may be rare, but they do happen. And in some cases, they can turn violent. According to AJN’s September 2008 article, “Nonfamily Infant Abductions, 1983-2006,” which compared cases from 1983–1992 with those from 1993–2006, from the earlier to the later period the preferred abduction location changed: the percentage of infant abductions from health care facilities decreased, while the percentage of those from private residences nearly doubled. In 22 of the 247 cases studied, the mother was killed, and in nine of the 22 cases, a cesarean section was performed to remove the fetus from the womb, as occurred in the Darlene Haynes story. Read the rest of this entry ?
Photo by Biology Big Brother, via Flickr
In our discussions of how to “brand” AJN, we on staff have sometimes referred to it as “the journal for the career-minded nurse.” I’ve often wondered who those nurses are. Some might think they’re that small percentage of nurses who go on for advanced degrees (only 13% of nurses, according to one source) or those who move into management positions.
But I see them differently. I think there are a lot more career-minded nurses out there than we give credit for. What about nurses in direct-care roles who strive to be the best clinicians they can be—aren’t they “career minded” too? They’re the nurses I looked up to when I was working in the hospital and hoped to be like some day. They keep the basic principles of good nursing in mind, combining compassion and evidence-based practice, behaving professionally, dressing appropriately, staying aware of health care trends, and advancing nursing by participating in unit- and hospital-wide committees and professional organizations.
It’s not always easy. I broke the “dress appropriately” rule once, and will never do that again! (A hospital is no place for snakeskin pants, I learned.) And what would a nurse manager think of my new nose ring? One recent blog post debates that issue.
In my definition, career-minded nurses also take their role as preceptor very seriously, showing patience and understanding to new nurses. We need more of this; as one nurse blogger, Not Nurse Ratched, put it: “I have many assets to bring to this profession and to my patients, and I hope I survive my first year without burning out so that I can keep those assets in this profession.”
Patients need smart, capable nurses at the bedside. Perhaps if those nurses start getting the respect they deserve, we can keep them there.
Christine Moffa, MSN, RN, clinical editor
Photo by karindalziel, via Flickr.
A study in the British medical journal Lancet warns that pregnant women infected with 2009 novel H1N1 had a higher rate of hospitalization and greater risk of death than the general population. From the Centers for Disease Control and Prevention (CDC) press release:
“The death of a pregnant woman is always heartbreaking, and unfortunately we have been hearing reports of otherwise healthy women dying from H1N1. If a pregnant woman feels like she may have influenza, she needs to call her healthcare provider right away,” said CDC’s Dr. Denise Jamieson, lead author of the study. “Clinicians who treat pregnant women should have a system in place for triaging pregnant women with influenza-like symptoms and they should not delay in initiating appropriate antiviral therapy. Some clinicians hesitate treating pregnant women with antiviral medications because of concerns for the developing fetus, but this is the wrong approach. It is critical that pregnant women, in particular, be treated promptly. “
Here’s a CDC page offering guidance for clinicians (last updated on June 30) on pregnant women and the 2009 novel H1N1 virus.
Leave a comment about whether or not you’re seeing increased concern among pregnant women who are patients, as well as how urgently you’re seeing clinicians respond.
Paper Money, Extreme Macro, by Kevin Dooley, via Flickr.
Health care reform is the hot topic of the moment. But of all the proposals being thrown around, which one will actually address the quality of care? In a July 5 op-ed piece for the New York Times, Paul O’Neill, former U.S. Secretary of the Treasury, asked, “Which of the reform proposals will eliminate the millions of infections acquired at hospitals every year? Which of the proposals will eliminate the annual toll of 300 million medication errors?” These are excellent questions that both lawmakers and clinicians need to consider. Read the rest of this entry ?
From Jason Pratt, via Flickr
A new report in Nursing Outlook (here’s the abstract) analyzes the experiences of new nurses. The news is not good. Actually, it’s really pretty awful when you think that much of what theses nurses complain about was documented in a book published in 1974 by nurse and researcher Marlene Kramer, Reality Shock: Why Nurses Leave Nursing.
The current report analyzes the nurses’ answers to an open-ended question that was part of a larger study of newly licensed registered nurses who’ve been employed less than 18 months. Researchers identified five themes among the 612 comments:
• Colliding expectations – The nurses expected the workplace to be more in keeping with what they were taught in nursing school; “high patient-to-nurse ratios were a particularly dominant source of stress.”
• The need for speed – The nurses felt there should have been more time for them to transition to carrying full responsibilities for patient care.
• You want too much – There were many complaints about the heavy workload, with little time to do it and little time to spend with patients.
• How dare you? – The nurses felt they were mistreated by nurse and physician colleagues and management.
• Change is on the horizon – Despite the many complaints about the workplace and the workload, the nurses described a hopefulness that things would improve. Read the rest of this entry ?
Karen Roush, AJN’s former editorial director, alerted me to a great story. A careful assessment by a nurse practitioner (NP) at St. Jude Children’s Research Hospital in Memphis, Tennessee, uncovered a potential reason for an infant’s HIV diagnosis. The staff at the hospital had been stymied in trying to ascertain how a nine-month-old infant developed HIV after earlier tests had shown her to be HIV-negative. The mother, who was HIV-positive, had not breastfed the child, nor was there evidence of injury or sexual transmission, and the infant had not received blood transfusions.
Marion Donohoe, the NP, in taking a detailed history from the mother, asked her about feeding practices, including pre-mastication. Yes, said the mother, she had been pre-chewing food for her daughter. Read the rest of this entry ?
Charla on horse 2-3 years ago; daughter Briana standing.
I recently had an e-mail exchange with Michael Nash, the twin brother of Charla Nash. Charla was the victim of a chimpanzee mauling in February of this year. I first wrote a post about her in April and then an update on her condition in May. In April, she had just spoken her first words, her daughter’s name and her nurse’s name, upon waking from a medically induced coma.
Michael tells me now that Charla continues to recover. Most of her physical wounds have healed, and she will soon be discharged to a rehab facility. She is blind and has prosthetic eyes. She also has had several facial-reconstructive surgeries, including the placement of a prosthetic hard palate. A large piece of her scalp was torn off in the attack, and that wound is still being treated (it requires wet-to-dry dressing changes three to four times a day).
Initially, her physicians were concerned about her mental and cognitive recovery. But it seems she’s doing better than expected. Her family is dedicated to supporting her throughout this ordeal: two brothers take turns staying in Cleveland to be near her at the hospital, and Brianna, her daughter, has been staying there over the summer. Yet still, Michael says, Charla is down at times. Here are Michael’s words about one of his most recent visits to her.
One day she told me I could go home. I told her I could stay a while longer. She said she meant to go home and get on with my life. I said I could not do that. She said that I could and I responded that I couldn’t and you know why I could not. She asked why and I said, because you would not leave me. She said that she would and I responded that you are lying, your nose is growing. Then she got very quiet but I am sure it was a turning point. Since then I feel she is back 100%.
He is planning a big surprise in August for Charla, but hasn’t revealed what it will be. Visit the Charla Nash Trust Website if you’d like to keep updated on Charla’s condition, or make a donation to help cover medical bills.
Christine Moffa, MS, RN, clinical editor
An example of the kind of misinformation that is being spread to scare people about health care reform can be found in the Allnurses.com post quoted below. The altered U.S. flag image to the left (by fletcherwarren, via Flickr) suggests, with perhaps intentional irony, the McCarthy-era fear-mongering about socialism that seems to underlie many such blanket dismissals of health care reform. What do you think? And where are people getting such information?
. . . I just want to know If Im the only person who is considering not doing nursing if the gov’t goes through with universal health care. I was talking to my manager about this tonight at work and he was saying that Im probably not going to want to do nursing since nurses will make $9 or $10 an hour. I know nursing isnt about money, but that kind of money isnt worth going into nursing. You cant even live off that amount of money! Nurses now say they dont get paid enough for how hard they work and how much they have to put up with. Am I the only thats thinking like this?
[EDITORS' NOTE: COMMENT THREAD ON THIS POST IS NOW CLOSED. THANKS FOR ALL YOUR COMMENTS.]
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