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Early Spring Web Roundup: Insomnia, Early Delivery, Persistence, Painkillers, Overtesting

April 6, 2012

Cherry Blossoms, Washington, DC/by cliff1066, via Flickr

We’ve been a little quiet here on the blog this week. Maybe it has to do with the opening of baseball season or signals a hangover from media coverage of the Supreme Court give-and-take about the Affordable Care Act last week and the endless guesses about how the court is likely to vote come June. Or maybe all our nurse bloggers are using spare time to clean out closets, sweep the cherry blossoms and sale inserts from the sidewalk, purge the inbox, box up the humidifier, watch Mad Men, or whatever. But here are a few things we’d like to draw your attention to:

If the windy spring nights wake you (or your patients) to the sound of a trash can lid flying away, maybe this will help: As described in the Drug Watch column in AJN‘s April issue, a sublingual form of the drug zolpidem (think Ambien) has now been approved, with the fancy name Intermezzo, for people who wake in the middle of the night and start hearing the same song over and over in their heads or thinking of the perfect comeback to that snippy waiter.

Also in the April issue, an AJN Reports looks at efforts to get people not to opt for potentially risky early delivery of their babies, and a Reflections essay called “Giving Up—Or Not” details one nurse’s patience and persistence in trying to get a patient to start wanting to live again after major surgery. Here’s an excerpt:

We encourage, beg, cajole, and nag him—to feed himself, to sit in the chair, to roll over. Healing is work, we tell him.

But his body has turned on itself as a substitute for food. His long series of complications has left him discouraged and depressed. If staying comfortable impedes his progress, he’s willing to live with the trade-off.

Sam opens his eyes when I walk into his room, then closes them again. While I assess him, I tell him the plans for the day.

He puts a finger over his trach. “Do I have to have a bath? I feel so tired.” His voice is soft and slightly rasping.

You might have noticed recent headlines about prescription painkiller abuse in the U.S. Some of them characterize painkillers as a kind of monster “tightening its grip” on us all. The data says it’s a very real problem, and nurses who work in EDs might be particularly sensitized to it because of the drug-seekers who use up their valuable time. At the same time, some voices are saying that it’s crucial to engage in rational problem solving rather than a generalized fear response, that some progress is actually being made on some fronts, that most people who are prescribed opiates neither become addicted nor abuse them, that some physicians are getting afraid of prescribing them out of fear of being prosecuted, and that, most importantly, chronic pain is still significantly undertreated in the U.S.  

OK, you probably heard, but in keeping with a growing understanding that we have to save money and that less can be more in health care, nine medical societies released a list of 45 tests and procedures we may not need.

And a housecleaning note: our blogroll is no longer visible in the right sidebar, though it still exists; the nursing blogs are now reachable by a link under the Pages tab near the top of the sidebar.—JM, senior editor

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