Archive for May, 2010

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Scientist, Healer, Nurse

May 10, 2010

. . . we’d sliced his chest cavity open during our dissection, rendering his beating heart clearly visible. He was pinned to a small tray and covered with a cheesecloth. I brought him home in a shoe box on a sparsely populated school bus, and placed him carefully on the coffee table in the living room.

If the above excerpt sounds like it’s lifted from the intimate memoirs of a torturer, it’s not. It’s from the May Reflections essay, “The Soul on the Head of a Pin,” which is written by Marcy Phipps (for the nicest version, click through to the PDF once you’ve reached the article at our Website). Marcy is a nurse who uses a simple, elegantly rendered childhood story to explore the sometimes unnerving gap inside every nurse between the roles of objective scientist and compassionate healer. -JM

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Think Twice Before Inserting That Feeding Tube

May 6, 2010

By Shawn Kennedy, AJN interim editor-in-chief


One of the news stories in the May issue of AJN describes the “down the road” implications for a common practice—the use of feeding tubes in patients with end-stage dementia. Feeding tubes are often placed in these patients in the acute care setting and remain as the patient moves to a nursing home for continued care.

“Feeding Tubes Used Too Often in End-Stage Dementia” discusses a study recently published in JAMA that sought to examine this practice and identify what factors are associated with its continued use “despite a body of literature showing that they aren’t effective in improving clinical outcomes or survival.”

This is an important read as it reminds us to question why we do what we do, how it will improve or enhance outcomes, and what are the implications of intervening versus not intervening? Do we “follow the protocol” because it’s convenient, or do we look ahead at implications for patients and families?

So how does your hospital stack up?

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What to Teach Patients and Their Families About Asthma

May 6, 2010

What do you need to know about asthma, and what should you teach your patients about its prevention and management? This month’s CE article gives a comprehensive and accessible overview, with medication, symptom, and common allergen tables, as well as advice like the following about the use of “action plans,” which may be particularly helpful with patients with “moderate or severe persistent asthma, a history of exacerbations, or poorly controlled asthma.” 

Action plans should be simple and easy to use. Many use a traffic light analogy, describing green, yellow, and red zones for which specific actions are prescribed. In the green (“go”) zone, patients’ [peak expiratory flow rate] PEFR is 80% to 100% of their personal best and they have no symptoms. These patients can continue using their daily medications and taking steps to limit exposure to triggers, as described in their plan. When patients’ PEFR is 50% to 80% of their personal best and they have symptoms, they’ve entered the yellow (“caution”) zone, and practitioners may consider prescribing alternative antiinflammatory medications and, possibly, a higher dose or more frequent use of the rescue medication. Patients whose PEFR drops below 50% of their personal best and whose symptoms fail to improve significantly with prescribed rescue medications are in the red (“danger–stop”) zone. They should increase medication as indicated in their action plan and call their health care provider immediately. If unable to reach their provider, they should stop what they’re doing and go directly to the nearest ED.

How are you doing with helping your patients and their families manage asthma?

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The Manifold Talents of Nurses Who Are Artists

May 5, 2010

By Sylvia Foley, AJN senior editor

Ferris wheel through the sunroof in the rain, by aturkus / Alan Turkus, via Flickr

As the coordinator of AJN’s Art of Nursing department, I’m intrigued by intersections between the two fields: Art and Nursing. About a year ago I profiled several multitalented nurses (The Triple Talents of Some Nurse Bloggers), including Julianna Paradisi, an RN, artist, and writer who blogs about “where science, humanity, and art converge” at JParadisi RN’s Blog. (Her painting Love You to Death appeared on our October 2009 cover.) In March Paradisi launched a second blog, Die Krankenschwester, which emphasizes images. One series depicts rituals followed “From Cradle to Grave”; another considers the iconography of call lights. Paradisi’s work is beautiful and thought-provoking; stop by and have a look.

Recently I happened upon Nurse–Artists International, Inc. Started in 2009 by Kathy Iwanowski, an artist and former oncology and hospice nurse, the organization has an ambitious vision that includes “promoting the arts, humanities, and the therapeutic benefits of creativity in all aspects of life and living,” “creating and collaborating on projects related to arts and health with corporate, educational, healthcare, and other community partners” and “assessing the impact of the arts on health and healthcare costs.” Among its programs are the International Association of Nurse Artists, with membership open to nurses working in any artistic medium; Our Space to Create, a collaborative program for developing arts projects that meet community needs; and the Arts and Health Co-Lab, open to anyone interested in the connection between the arts and health. Iwanowski’s personal Web site offers samples of her found-object sculpture and visual art.

Art by Nurses states that its aim is to “bring nurses together as a community using art as a powerful self-care resource.” Based in Vancouver, British Columbia, Canada, it offers members an online venue for showing and selling art. A percentage of works sold goes into an Art Fund for Nurses, to which “any registered nurse can apply for funds to use art as a strategy to maintain balance and meaning in their lives as healers.” Worth a visit simply for its Art Galleries, which include striking photographs and artwork by more than 20 nurse-artists, including founder Lynda MacLeod, Shona Lalonde, and Pasquale Fiore, as well as Catherine Fraser, whose watercolor “Herb Store” was featured on AJN’s August 2007 cover.

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Tooting Our Horn

May 3, 2010

By Shawn Kennedy, AJN editorial director/interim editor-in-chief

I know some people think it’s crass and self-serving to announce awards.  Sometimes I agree, especially if it’s the “I” award – I did this, I did that, I’ve been named to this or that commission.

But I have to announce these awards because not to do it is unfair to the many  people who work very hard behind the scenes to get each issue of AJN out the door and in your hands. Every reference and every fact is checked; articles are edited, second-edited, copyedited, and then proofread multiple times. There’s a pre-edit meeting with the author; there’s an art meeting; there are weekly editorial meetings. It takes editors, freelancers, clinical editors, knowledgeable authors with great stories, copyeditors, a librarian, our talented design and production teams, and our editorial and department coordinators to work together to develop each article, each issue. Some of the people who took part in working on these pieces are no longer here and I will be sure they learn about these awards, as it is truly a team effort.

So it’s with pride and thanks to those who made it happen that I share our news about the six (count ‘em – six!) awards to AJN announced by the American Society of Healthcare Publication Editors (ASHPE):

GOLD award – Feature Article

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

The Vietnam Women’s Memorial: Better Late Than Never

Kay E. Schwebke; May 2009;


SILVER
award – Signed Editorial 

Who’s Watching?

Diana J. Mason; March 2009 


SILVER award –
Cover Photo

Street Nurse 

Nettie Wild; July 2009

 
SILVER award – Opening Page, Computer Generated

Stopping Eating and Drinking

Judith K. Schwarz; September 2009


BRONZE award –
Blog Post [!] 

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

Douglas Olsen; August 2009

 
SILVER award – Special Supplement

Transforming Care at the Bedside: Paving the Wave for Change

November 2009

Click on the links and check out our award winners. Don’t forget to listen to podcasts that may be associated with the articles (my favorite: the poems written by nurses who served in Vietnam).  And you can see all the winners of ASHPE awards here. Or maybe just browse our current issue, entirely free until May 15, after which time only certain departments and selected articles will be free (as they usually are).

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