Archive for August, 2009

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To Promote Healing, Quiet the Din: What Nurses Can Do

August 31, 2009
Hospital Quiet by striatic / hobvias sudoneighm, via Flickr

First Steps - Quiet by striatic / hobvias sudoneighm, via Flickr.

By Sylvia Foley, senior editor

Like many city dwellers, I often find myself battling excessive noise. My apartment is across the street from a large city park, and although I’m grateful for the greenery, in the summer my neighbors and I have to contend with the outsize noise from bandshell concerts, impromptu sidewalk parties, and ramped-up car stereos.  Frequent construction projects and an unrepentantly loud neighbor often add to this racket.  It’s caused me to lose sleep, jacked up my blood pressure, and messed with my concentration.  Indeed, when I was hospitalized with pneumonia briefly a while back, I actually found the quiet of the hospital a balm. Turns out I was lucky in that regard.

Hospitals are often noisy places.  In this month’s Patients First column, authors Kimberly N. Montague and colleagues examine the “near-constant din created by equipment, hallway traffic, and conversation” that’s common in many hospitals. They point out that Read the rest of this entry ?

Posted in healing/holistic, nursing innovations, nursing perspective, practice tips | 2 Comments »

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(What’s So Funny ‘Bout) Peace, Love, and Meditation?

August 28, 2009

By Christine Moffa, MSN, RN, clinical editor

By alicepopkorn/via flickr

By Alicepopkorn/via flickr

A small study published in the June issue of Health Education and Behavior found that mindfulness meditation in the workplace lowered stress levels and improved sleep. The findings have made the rounds on the Internet, with several blogs and Web sites reporting the results and giving their own spin on the value of the intervention. I also wrote about it for the AJN eNews, (delivered by e-mail inbox if you sign up), where each month I’m writing a column called “Taking Care of You.”

Evidently, caring for themselves is a foreign idea to some nurses. At the Nursing Times Web site two anonymous nurses posted the following comments about the notion of meditating while at work:

“Morale is at rock bottom. So please don’t make them completely hysterical with the suggestion that meditation during their lunch breaks would be useful in helping them ‘attain a heightened awareness of the factors that cause them stress’.”

“…we don’t get ANY breaks. And I think the notion of being able to sit at the desk in the nursing office is a very bad joke.”

That second commenter goes on to suggest that what’s needed isn’t meditation but rather more staff.

AJN writes a lot about the staffing issue, and it’s a real one. But the question remains: is “mindfulness” a part of your self-care arsenal? And if not, are you more pessimistic than you should be? After all, Tindle and colleagues reported findings in Circulation earlier this month showing that “cynical, hostile women” had higher rates of coronary heart disease than optimistic women did.

Maybe you have more power than you think.

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Posted in healing/holistic, nursing perspective, practice tips, spirituality and nursing | 1 Comment »

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Soccer Brain: Teaching Families about the Dangers of Head Injuries in Youth Sports

August 27, 2009

By Diana Mason, AJN editor-in-chief-emeritus

soccerI’ve been disturbed by a relative’s seeming lack of concern about his teenage son’s repeated head injuries from playing soccer. I think he doesn’t believe what I tell him about the long-term consequences of head injuries sustained in sports such as football and soccer. So brava to Jane E. Brody, the New York Times Personal Health columnist, for writing about it. She included a symptom guide that sets out what’s of concern and the importance of monitoring those with head injuries for at least 72 hours.

Every emergency room nurse and any nurse who attends youth sporting events should share this article with the parents of children who play contact or collision sports. I’m sending it to my relatives. See AJN’s article on combat-zone traumatic brain injuries for more on the topic.

Posted in Diana Mason, editor-in-chief emeritus, nursing perspective | Leave a Comment »

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Is It Ethical for a Nurse to Decline the H1N1 Vaccine?

August 26, 2009

By Douglas Olsen, PhD, RN. Olsen is an AJN contributing editor who co-coordinates the journal’s Ethical Issues department and a nurse ethicist with the National Center for Ethics in Health Care at the Veterans Health Administration in Washington, DC. The views he expresses here are meant to stimulate discussion of this topic and not to serve as pronouncements guiding what nurses should or shound not do. The views are his alone and should not be construed as representing those of AJN or of the National Center for Ethics in Health Care or the Veterans Health Administration.

MailOnlineFluJabScreenshotPublic health experts advocate widespread flu vaccination for people who give direct care to patients. However, in the past less than 40% of health care workers have been vaccinated for flu, and in a recent Nursing Times survey from the UK 30% of nurses said they would decline H1N1 vaccine and only 37% said “Yes” they would take the vaccine. Here are some thoughts on how to sort out the question from an ethical perspective.

Nurses, as patients, should be accorded the same respect for their decisions about health care, including the right to refuse a treatment, that is due to all patients. In ethics this is called respect for patient autonomy.

Professional obligation. However, nurses have a professional obligation to do as much as is reasonably possible to care for their patients. This includes incurring a certain amount of personal risk in giving care. Nurses incur risk on the job all the time from infections, violent patients, and many other sources.

In 2006 the American Nurses Association (ANA) put out a position paper that gives some guidance on the degree of risk that’s reasonable for nurses to accept in giving patient care: “[t]he benefit the patient will gain outweighs any harm the nurse might incur and does not present more than an acceptable risk to the nurse.”

Risk versus benefit. And so, the question is whether the degree of benefit expected for patients outweighs the degree of risk from the vaccine.  Read the rest of this entry ?

Posted in ethical issues, H1N1 virus (swine flu), international nursing | Tagged , | 32 Comments »

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Nurse Organizations Oppose Move to Allow Non-Licensed Personnel to Give Insulin to Students (Despite ADA Testimony Supporting the Practice)

August 25, 2009

By Shawn Kennedy, MA, RN, editorial director and interim editor-in-chief

By Mel B./via Flickr

By Mel B./via Flickr

A scenario is playing out in California that may have far-reaching consequences for nursing and for school children with diabetes. At issue is a move by the California Department of Education to allow non-nurse, unlicensed school personnel—teachers, aides, administrators, and others—to administer insulin to children while at school or at school functions if licensed personnel are unavailable. Read the rest of this entry ?

Posted in legal issues, nursing perspective, nursing shortage, school nurses, Shawn Kennedy, AJN editor-in-chief | Tagged , , , , , | 1 Comment »

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Obesity and Advice: Should Nurses Practice What They Teach?

August 24, 2009

YphantidesArticleScreenshotI recently read a story that was blunt about the contradictions of being an obese health care provider. I don’t consider myself overweight or obese, but maintaining a weight I am happy with is an ongoing challenge. Dr. Nick Yphantides, who says that he lost over 250 pounds, got tired of telling patients, “Do as I say, not as I do,” and realized that he needed to change if he expected patients to take his message to heart.

Nurses are teachers in the most basic sense. We often take advantage of “teachable moments” with our patients on a variety of topics. One of our primary roles is that of educator. As a student, I found myself most drawn to teachers I could relate to—those that “walked their talk.” One of my favorite professors taught my psych rotation both in the classroom and in the clinical setting. She made our rotation interesting, not scary, and was an amazing role model on many levels. I remember her as calm, intelligent, and empathetic. She was also stylish and fit. As a 19-year-old student, I thought she was pretty cool. One of my first positions after the highly recommended but dreaded “year in med-surg” was as a staff nurse in a psychiatric unit. I loved it, and often found myself drawing on past lessons from my admired teacher.

How important, then, is “walking what you talk” when it comes to patient education? Read the rest of this entry ?

Posted in professional identity | 1 Comment »

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Blogging Nurses: Latest ‘Change of Shift’ Roundup Now Up at Emergiblog

August 21, 2009

ChangeofShiftScreenshotWant to keep up with the nursosphere? The most recent Change of Shift, a regular compendium of links to blog posts by nurses, nursing students, and sundry others is now up over at Emergiblog.
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Posted in nurse practitioners, nursing perspective, nursing students, practice tips, professional identity, writing and nursing | Leave a Comment »

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Stopped Caring About Health Care Reform? Maybe There’s a Cure…

August 21, 2009

The health of the health care system will affect you as professionals and as citizens for a long time to come. But if you’re not political activists on the left or the right, there’s a good chance that, like many busy people, you’ve grown pretty sick of the daily news on the topic. Why? Here’s an excerpt from an excellent post on what’s missing from the news and why this means that so-called up-to-the-minute news can hide the real story as often as it can reveal it:

At the scale of news, almost every story looks complicated. Health reform is an impossible-to-follow morass of Congressional committees, policy proposals, industry talking points, and think tank reports. Pull back the lens a bit, however, and you see a fairly straightforward story whose basic contours haven’t changed all that much since 1994. Read the rest of this entry ?

Posted in health care reform, nursing perspective, Uncategorized | Leave a Comment »

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Why is the Media Silent on Internationally Tested Single-Payer Option?

August 20, 2009

Here’s an excerpt from a recent article on the single-payer option for health care reform that appeared in the Online Journal:

As a civilized nation, we would never tolerate a system where police or fire services were treated as optional for some residents. To understand how utterly absurd our private health care system is, imagine life in America if we treated police and fire services the way we now treat most health care services.

Photo courtesy of California Nurses Association.

Photo courtesy of California Nurses Association.

In fact, we posted back in May about nurses who got arrested protesting the tabling of the single-payer option by a Senate Finance Committee. But since then, the media has been largely silent on the single-payer option, despite the fact that some version of it serves as the foundation of the health care system in most other prosperous industrialized nations. These nations are neither socialist nor communist, but their citizens have higher average life expectancies than our own. In these places, health care is viewed as an essential service rather than something each and every person may or may not be able to afford at any given time—depending on such variables as work status, marital status, health status, income level, genetic makeup, luck, place of residence, and so on.

Does it really make sense that no one is even talking about this option? Compare this silence to the amount of coverage devoted to false claims about “death panels“ in the media in recent weeks. Is this imbalance in coverage serving the interests of the American people? 

Jacob Molyneux, senior editor/blog editor

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Posted in health care reform, nursing perspective | 2 Comments »

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Of the Making of Reports There Is No End: Hillary Visits Congo, But When Will UN Move to Stem Violence Against Women?

August 19, 2009

June09AJNReportsScreenshotLast week, when United Nations Secretary-General Ban Ki-moon called for yet another commission to look into the use of rape as a strategy of war in the Democratic Republic of Congo (DRC), Chad, and Sudan, I almost laughed. Just what these women need, I thought—more words, platitudes, and denouncements by politicians. Ban’s statement calling for UN members to “come together and act” was made around the same time U.S. Secretary of State Hillary Rodham Clinton was embarking on an official visit to the area. She visited a refugee camp in Goma and promised $17 million to support programs for victims of sexual violence. Perhaps the UN felt it was being upstaged and so needed to do some posturing.

In the June issue of AJN, I coauthored a report on the increasing violence against women worldwide. In researching the article, I was shocked to learn how many reports and commissions and “special rapporteurs” have documented the violence, and for how long:

• The Guardian UK notes that “the UN has recorded at least 200,000 cases of sexual violence against women and girls in the region since the conflict began in 1996.”
• A 2000 report by the Organization of African Unity on the 1994 Rwandan genocide noted that “practically every female over the age of 12 who survived the genocide was raped.”
• In 2005, WHO reported that there were 40,000 survivors of sexual violence in the DRC—and that was four years ago.
• In February 2008, the UN commissioned an investigative report of violence against women in the DRC. It confirmed the large numbers of mass rapes and also that many of the perpetrators were members of the army, the police, and even the UN peacekeeping force. Read the rest of this entry ?

Posted in human rights, international nursing, Shawn Kennedy, AJN editor-in-chief | Leave a Comment »

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