Archive for August, 2009

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Trauma Nurse Finds Stress Relief as DJ–What Do You Do?

August 7, 2009

DJDharmaScreenshotA little over 10 years ago I met Christine Moffa, AJN clinical editor, while working as a travel nurse in Miami. I lived on South Beach and she lived in “the Grove.” We took turns playing in both of our neighborhoods, since they offered different attractions.

Travel nurses may have a higher tolerance to stress than the average person, but it was always good to finish a shift on our busy pediatric floor and walk out the door. I remember my Miami assignment as difficult but a lot a fun. Our patient population had a lot of variety, requiring us to draw upon many resources as well as past experience to handle the load. Even with the difficult working conditions, I remember taking time to see the town, eat at great restaurants, and take in the local flavor as a way to offset the workload.

A recent article in the Miami Herald highlights Kate Emily Yeadaker, a trauma nurse who has a unique way of relieving her job stress. DJ Dharma, also known as ’the Night Nurse,’ spins tunes for dance clubs in Miami. Read the rest of this entry ?

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CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1

August 7, 2009

AJN received this advisory earlier this week from the CDC:

swineflu2In July 2009, CDC’s Advisory Committee on Immunization Practices (ACIP) made recommendations on who should receive vaccine against novel influenza A (H1N1) when it becomes available, and which priority groups should be vaccinated first if the vaccine is initially available in extremely limited quantities. Five key populations were focused on by the committee to help reduce the impact and spread of novel H1N1. The key populations include those who are at higher risk of disease or complications, those who are likely to come in contact with novel H1N1, and those who could infect young infants. The committee recommends that when the vaccine becomes available, the following groups, accounting for approximately 159 million people in the United States, should receive the vaccine first:

• pregnant women,
• people who live with or care for children younger than 6 months of age,
• health care and emergency services personnel,
• persons between the ages of 6 months through 24 years of age, and
• people from ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.

The committee does not expect that there will be a shortage of novel H1N1 vaccine, but availability and demand can be unpredictable. There is some possibility that initially the vaccine will be available in limited quantities. In this setting, the committee recommended that the following groups receive the vaccine before others:

• pregnant women,
• people who live with or care for children younger than 6 months of age,
• health care and emergency services personnel with direct patient contact,
• children 6 months through 4 years of age, and
• children 5 through 18 years of age who have chronic medical conditions.

The committee further recommended that once the demand for vaccine for these prioritized groups has been met at the local level, programs and providers should begin vaccinating everyone from ages 25 through 64 years. Current studies indicate the risk for infection among persons age 65 or older is less than the risk for younger age groups. Therefore, as vaccine supply and demand for vaccine among younger age groups is being met, programs and providers should offer vaccination to people over the age of 65.

The committee also stressed that people over the age of 65 receive the seasonal vaccine as soon as it is available. The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine. It is intended to be used alongside seasonal flu vaccine to protect people. Seasonal flu and novel H1N1 vaccines may be administered on the same day.

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Rating AJN’s Coverage of Nazi Atrocities: Is Silence Ever an Option for Nurses?

August 6, 2009

DisplacedChildrenGermany1952

One of the feature articles in the August issue takes an unflinching look at a shameful yet little-known episode of nursing history: “The Third Reich, Nursing, and AJN by Mary Deane Lagerwey, PhD, RN, examines AJN’s coverage of events in Germany during the Nazi era—before and during WWII—and in the postwar years, and compares the reporting in this journal with that of other professional and popular journals of the day, such as Life and JAMA.

The atrocities committed by Nazi physicians during this period are notorious, but the complicity of many German nurses in the Holocaust is not nearly as well known. Lagerwey, an associate professor at the Western Michigan University Bronson School of Nursing, analyzed two decades of AJN’s articles on nursing-related developments in Germany and found that, in the interest of promoting an image of international unity and cooperation among nurses, this journal failed to report on the increasing marginalization and exclusion of Jewish nurses before the war and to hold nurses who were guilty accountable in the postwar period. Read the rest of this entry ?

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Subtle Bias Against Nursing Profession In NY Times Piece on Cuban Docs In U.S.?

August 5, 2009

NYTimesCubaScreenshotA few years ago I was sitting around a table with nursing leaders in Washington, D.C., discussing various ways to remedy the pending nursing shortage. One idea brought up was to train foreign physicians ineligible to practice medicine in the U.S. to be nurses. Part of the argument was that, since they were already trained as doctors, they would be able to learn to practice as nurses in a much shorter period of time.

I never agreed with that thinking. As we learn nursing we are learning a lot more than anatomy and physiology. We are learning to connect with our patients, to have compassion, and to work as a highly skilled team member. It is a different way of connecting with the patient than that of the physician. And nurses today have a lot more to learn and apply than ever before because of the increased complexity of health conditions, the increasingly complex health care environment, and the needs of the populations we care for. Read the rest of this entry ?

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How Are Nurses Using Smartphones at Work?

August 4, 2009

Here’s a recent post from Not Nurse Ratched that lists five things she uses her iPhone for at work: the programs/apps or features she uses are Epocrates, the calculator, Ratios, DrugInfusion, and Instant ECG. A Web site called Software Advice recently sent us the results of a useful survey on the use of smartphones among medical personnel. The figure below shows the most popular uses of smartphones at work, not just for nurses but for a variety of health care industry workers. 

Note: survey focused on health care industry workers, one subgroup of which was nurses

We know many nurses have already begun to use whatever smartphone they may have to access 5-Minute Clinical Consult, a Wolters Kluwer product (full disclosure: AJN is owned by Wolters Kluwer) that “provides instant access to the essentials of 700+ medical conditions” and ”includes dermatology images, videos of medical procedures, AAFP patient handouts, drug database and more.” It can be downloaded to many types of mobile device — iPhone, BlackBerry, Palm, Android, or Windows Mobile.

But let us know: how are you using smartphones/handheld devices at the bedside? If not, do you plan to start using one? And do they really help?
-Jacob Molyneux, senior editor/blog editor
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“I Don’t Want My Arm to Blow Up”: Dealing with Post-Breast Cancer Lymphedema

August 4, 2009
Wearing a night compression garment. Copyright Mei R. Fu. All rights reserved.

Wearing a night compression garment. Copyright Mei R. Fu. All rights reserved.

“I don’t want my arm to blow up,” says one breast cancer survivor, talking frankly about her struggle to manage post–breast cancer lymphedema.  She’s quoted this month in Part 2 of AJN‘s two-part article on the condition, which is  characterized by an abnormal accumulation of lymph in the arm, shoulder, breast, or chest.  In Part 1 (July), authors Mei Fu and colleagues described its pathophysiology and diagnosis. This month they discuss current approaches to risk reduction, treatment and management, as well as the nursing implications.

Effective risk reduction and management involve several strategies. For example, the authors emphasize the need to

  • prevent infection by performing daily skin care and treating punctures, cuts, abrasions, and insect bites with a topical antibiotic.
  • prevent injury by avoiding injections in the affected area and using caution when cooking.
  • prevent muscle strain by avoiding overuse of the affected arm and wearing a compression garment during strenuous activities.
  • avoid restriction of the affected area by avoiding having blood pressure  measured on the affected arm and wearing loose-fitting clothing and jewelry.
  • avoid excessive heat by avoiding prolonged exposure (as in a sauna or hot tub).
  • promote lymph drainage by elevating the affected arm above the level of the heart for short intervals daily and by engaging in regular, light aerobic exercise.

For the complete list of strategies, see Table 1 in the article. And check out this earlier post on how bloggers cope with lymphedema.

— Sylvia Foley, AJN senior editor

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Nurse Bloggers Not Afraid to Tackle Health Care Reform

August 3, 2009

“Nurse Ratched” is a blogger who recently took the initiative and got an interview with former Vermont governor Howard Dean about health care reform. It’s great to see nurses who are helping take citizen journalism to the next level. 

And here’s a very sensible, open-minded post at Florence dot com about the health care system in Canada and whether it’s as frightening and awful as it’s made out to be.  (Hint: she thinks it isn’t. And yes, we just mentioned this blogger in our last post. We’ll stop now!)

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Nurse Whistle-Blowers Pay Heavy Price For Doing the Right Thing

August 3, 2009
By hellosputnik, via Flickr

By hellosputnik, via Flickr

Late Friday afternoon I spoke with Clair Jordan, the executive director of the Texas Nurses Association. Jordan and others at the TNA have been working in support of two Texas nurse whistleblowers, Anne Mitchell and Vicki Galle, who in June were fired from their jobs, arrested, and indicted on third-degree–felony criminal charges, Jordan said. Mitchell and Galle had filed an anonymous complaint with the Texas Medical Board against a physician at their workplace, Winkler County Memorial Hospital, in Kermit, Texas. The nurses believed the physician to have acted in ways that jeopardized patient care; the complaint, in documenting examples of this care, identified patients by their case number. The physician complained; the local sheriff investigated; charges were filed; the nurses lost their jobs. Read the rest of this entry ?

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