Archive for the ‘children's health’ Category

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Gym Class, or Physical Education?

May 23, 2012

Photo by Krossbow, via Flickr

By Michael Fergenson, AJN senior editorial coordinator

Gym class. Some of us may have memories of a brusque man tossing a ball into the middle of the gym, telling us to play and occasionally blowing a whistle. Popular culture certainly portrays the “gym teacher” in this way—or worse, sometimes they’re cast as the villain. I put gym teacher in quotes in the last sentence because my dad would get angry with me if he heard that term, or “gym class” for that matter. My father considers himself a physical educator. When people call him a gym teacher, which is most of the time, he replies with the quip: “The gymnasium is the room that I teach in, but I am a physical education teacher.”

There’s something more important going on here than mere semantics. Is this pop cultural view of the gym teacher causing harm to students? I believe so.

My father has been a physical educator for a little more than 20 years. For a long time I had the same negative view of gym teachers as most people. That was until I began to study education myself. I definitely wasn’t going to be a gym teacher—oh no, it was literature for me. I would be a high school English teacher, but that didn’t sound quite right. It reminded me of my dad’s quips. I wasn’t going to teach English, I was going to teach literature. That thought stayed in the back of my mind until, for a class assignment, I went to watch my dad teach. That’s when I finally realized the difference between a gym teacher and a physical education teacher.

My dad didn’t just toss a ball and tell the kids to go play. He was teaching these kids how to be physically fit. He taught them proper nutrition, how the different muscle groups work, the types of exercises that one could do to achieve results—and that was just the beginning. He taught the difference between exercises for muscle strength, muscle endurance, and elasticity. He showed them the proper way to stretch and the proper way to cool down. In short, he was teaching his elementary school class how to be physically fit.

More importantly, he was instilling a love of his subject in his students. That is the goal of any good teacher, because it means the students will continue to learn that subject and delight it in long after they have left school.

Unfortunately, not everyone has seen real physical education. More unfortunately, those making education policy don’t seem to have either. We all know that physical education budgets are being cut around the country, because it’s seen as unnecessary. However, studies such as this one, which was recently published in the American Heart Journal, show that proper physical education can help reduce the current obesity epidemic among American children. Read the rest of this entry ?

Posted in children's health, public health nursing | Tagged , , , , , , | 1 Comment »

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States Easing Up, Pediatricians Buckling Down on Childhood Immunizations

February 21, 2012

By Shawn Kennedy, MA, RN, AJN editor-in-chief

Two newspaper reports last week showed the dichotomy that exists in attitudes about mandating vaccines for children.

On February 15, the Wall Street Journal reported that more pediatricians are turning away families who refuse to have their children receive immunizations.

Day 4 measles rash/ CDC, via Wikimedia Commons

The next day, USA Today reported that several states are considering changing laws that currently allow parents to opt out of mandatory vaccines only for religious reasons, and extending the opt-out to include “philosophical reasons.” These reasons invariably come back to parental fears that vaccines put their children at high risk for autism. (See the our November 2011 report on what fueled this controversy.)

Highly publicized resurgences of measles and pertussis seem to have done little to change some parents’ mindsets about the need for immunizations. Has the success of the vaccines campaigns lulled some into a false sense of security—that the “risks” of vaccines, though unproven, are more dangerous than the diseases or their complications?

I shared in an editorial a story of a childhood friend who was left paralyzed in his lower extremities from contracting polio in childhood. And a cousin has a child, now almost 40 years old, who was left blind and speechless from encephalitis following measles contracted when she was five years old.

Cases like these are rarely seen anymore, but will they become more commonplace with more parents refusing to let their children receive vaccines? These are very real risks that many don’t think about. We need to continue to educate parents on the science that supports vaccine administration.

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Posted in children's health, Shawn Kennedy, AJN editor-in-chief | Tagged , , , , , | 10 Comments »

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On Cats Sucking the Breath Out of Babies, and Other Health Superstitions

February 15, 2012

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

I recently babysat a friend’s busy toddlers, and was happy to share the long (but lovely) day with a good friend who happens to also be a nurse. We’d just gotten the babies tucked into their cribs and were stepping out of the nursery with a sigh when I noticed the family’s cat lounging in a padded rocking chair, blinking lazily at us.

“Wait!” I said, scooping up the cat. “We can’t leave the cat here. Cats suck the breath out of babies!”

My friend looked at me like I’d lost my mind, and I instantly wished that I hadn’t said it.  The absurdity of the statement was clear to me. And yet it felt like a truth I’d known forever, even if I couldn’t remember why.

As it turns out, it was something I was told as a child—by my grandmother. Knowing this makes my statement make sense, at least to me, as I adored my grandma and would have accepted anything she told me as undisputed truth. Even so, I’m surprised (and a little embarrassed) that in spite of higher education and years of nursing experience, despite the obvious physiologic impossibility of a cat sucking the breath from a baby, and despite the fact that I’ve had my own children, and cats, such a notion was lying dormant in my consciousness and escaped unexpectedly and unbidden.

In my curiosity about the idea of cats sucking breath from babies, I came across a 1930 book, Shattering Health Superstitions, by Morris Fishbein, MD. It’s subtitled “An Explosion of False Theories and Notions in the Field of Health and Popular Medicine.” Dr. Fishbein discusses 57 medical claims, asserting their fallacy only after explaining their origin.

Here are some of the chapter titles, verbatim:

  • Some people think that fish is a brain food and that a lot of mackerel in the diet will convert a moron into an Einstein.
  • Some people believe that warts can be removed by tying knots in a string and burying the string at a crossroads in the moonlight.
  • Some people think appendicitis is just an old-fashioned stomach ache and that the doctors developed the disease for their own satisfaction.
  • An apple a day keeps the doctors away.
  • When the oldest inhabitant begins to feel pain in his joints, there is going to be a change in the weather.
  • It takes whiskey to kill a cold.
  • A favorite Midwestern cure for rheumatism is to carry a buckeye in the trousers pocket.
  • Kissing can cause trouble, but it doesn’t cause cold sores.
  • Most people believe that a big head is sure evidence of a massive intellect.

While there may be a shred of truth in a couple of the beliefs alluded to in these chapter titles (many people with arthritis certainly do report worsening symptoms with changes in the weather; many claims have been made for the benefits of fish oil of late; etc.), most have as much basis as certain more recent widely held beliefs regarding the various evils of vaccinations. Read the rest of this entry ?

Posted in children's health, nursing perspective | Tagged , , , , | Leave a Comment »

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Kudos to Indy for Tightening Human Trafficking Laws Before the Super Bowl

February 3, 2012

Market St., Indianapolis/ via Wikimedia Commons

According to Stateline.org (a news site of the nonprofit Pew Center on the States), with the Super Bowl taking place this Sunday in Indianapolis, the state of Indiana has decided to toughen up its human trafficking laws.

“Though it is an honor for Indiana to host the Super Bowl, many sincere voices have brought to light the fact that human trafficking is a shameful practice we can’t ignore,” Indiana attorney general Greg Zoeller said in a statement.

The article notes that sex trafficking during highly publicized events has become an issue for many states with hosting duties. While the Global Alliance Against Traffic in Women, an international advocacy group, claims that the estimates of trafficking cases at previous Super Bowls may have been too high, whether there are 60,000 or six in a given year, any number over zero is too many.

For more info, see our award-winning article on the nurse’s role in combating human trafficking, by Donna Sabella. She also talks about her work in a podcast.—by Demaris Bailey
 
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Posted in children's health, human rights, nursing perspective | Tagged , , , , , | Leave a Comment »

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Tilting the Earth

January 30, 2012

Elizabeth R. Plumer, PhD, JD, is a biochemist and intellectual property attorney. She lives in Saco, ME.

When an MRI revealed that my four-year-old daughter’s brain cancer had returned, I took the only action possible: I bought a dog. I scoured the Sunday papers and found just the puppy I was looking for, a Rottweiler. No deep psychological analysis was necessary to decipher my choice. I wanted a dog to protect my daughter from external threats, even if it could not protect her from the one threat that mattered most.

We named our puppy, Maggie, after Rod Stewart’s Maggie May, because from the moment she entered our lives, she stole our hearts. Maggie whimpered through that first night until I fell asleep on the couch with her gently snoring on my chest.

It was like having a newborn in the house again, and just as I had filled photo albums of my daughters, I took pictures of Maggie and my girls together. In one, taken the first summer we had her, Maggie lies in the shade beneath the swing set as if on sentry duty for my four-year-old and her seven-year-old sister. My girls hold steady on their swings and smile into the camera. The younger one wears one of my husband’s T-shirts over her bathing suit and sports a pixie haircut, the short hair a legacy of her recent surgery and radiation treatments. In my mind, the still photograph morphs into action as my daughters jump off their swings and pounce on Maggie, who luxuriates in the attention and rolls over to request a belly rub.

My younger daughter was 18 months old when she was first diagnosed with brain cancer. Her tumor was an astrocytoma, named for the star-shaped cells from which it had originated. Her tumor was benign, a meaningless term since benign brain tumors can be just as deadly as malignant ones, if left untreated. The location of my daughter’s tumor made it impossible to completely excise without risking paralysis. Radiation treatments were not recommended for children under six because of their harmful effects on a child’s developing brain. The surgeon removed as much of the tumor as possible. The rest was left behind until a second operation became inevitable.

When my daughter turned four, an MRI showed that the tumor had increased in size, she underwent a second operation to reduce the mass as much as possible. This was followed by daily radiation therapy for eight weeks. The doctors gave my daughter a one in three chance of surviving five years. Read the rest of this entry ?

Posted in children's health, patient perspective | Tagged , , , , | 4 Comments »

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The Dance of Empathy

October 25, 2011

By Peggy McDaniel, BSN, RN. An infusion practice manager currently based overseas, Peggy has written for this blog a number of times in the past.

by Augustin Ruiz, via Flickr

Although it’s only late October, this time of year finds me pondering holidays past, which were often spent working at a hospital. As a younger nurse, I worked in a neuro-trauma-rehab unit at a large children’s hospital. We had a strong primary nursing model and often cared for the same patients throughout their stay, which could last days, weeks, or months. Memories of patients from that unit and others occasionally come back to mind at this time of year, often spurred by holidays.

One of my first assignments was a beautiful youngster who had suffered a brain injury. It was a difficult case and the family spent many hours on our unit, helping me provide basic care and praying for a recovery. But after more than three months, the child’s strong and previously healthy body stopped fighting and the child passed away, with family at the bedside.

Years later, after being away from this facility, I returned for a short stint as a per diem on the float team. I dropped in to work when and where needed, days or nights. Many of the same people I’d loved working with were still there, and I often floated up to my comfortable “home base.”

One evening, after a long 12-hour day, as I was getting ready to tape report in the lounge behind the nurse’s station, I realized that voices out at the desk sounded familiar. I heard a voice ask, “Does anyone remember my child?” This voice, uttering a child’s name that I couldn’t forget, drew me from the lounge and around to the other side of the desk. The mother and two siblings were there, with a big fruit basket and flowers to leave for the nurses. We hugged and chatted. They couldn’t believe I was there—they had come every year for this anniversary and found fewer and fewer nurses who remembered the person they would never forget. I told them it was a sick call that had brought me in to that unit, and said that for some reason I had been thinking about their family that evening. Though it had been more than 12 years, they weren’t surprised, and I supposed I wasn’t really either.

We touch people as nurses. We provide intimate care such as bathing, dressing, and feeding. We also inflict pain with our touch, although it is done for a reason, with care and concern. How do our patients touch us? Do we let them in just enough so that we can provide emotional support along with the required physical care, somehow without losing our focus and ourselves? Read the rest of this entry ?

Posted in children's health, nursing perspective | Tagged , , , | 4 Comments »

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Blind Spot – At the Intersection of Mother and Nurse

October 6, 2011

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Being a nurse has changed my reactions to situations at home. For one thing, I don’t get overexcited about non-life-threatening medical problems. I can hardly stand the thought of going to an emergency room (Steri-Strips and ice are my usual “go-to” treatment plans). I’d like to blame this on working in a trauma center—it makes sense that seeing catastrophic injuries every day tends to make less severe injuries look insignificant—but I’m not sure that completely excuses my recent diagnostic error.

My son, who’s 12, came home from school last week complaining that his hand was sore. He’d hit a wall in gym, he said, but it was a padded wall, and he hadn’t hit it very hard. Still, he was absolutely certain that, at the very least, he’d dislocated something, and that, most likely, he’d broken his hand.

To my defense, he has a history of overdramatizing situations, and I took his self-assessment with a grain of salt. Although the side of his hand was slightly swollen, nothing was bruised, and everything seemed to be moving all right.

We iced it, of course, and although hand pain didn’t seem to interfere with his usual activities, he proceeded to tell anyone who would listen that he’d broken his hand.

“Stop saying that!” I told him. “You did not break your hand!”

And so it went, for an entire week. Until his volleyball coach mentioned, kindly, that my son had been complaining quite a bit, and asked if I thought I should have his hand looked at.

So I took him for an X-ray, certain we’d be sent on our way with education about soft tissue injuries. I certainly didn’t expect to find out my son had a “boxer’s fracture” (see image above), or to find myself sitting in the office of an orthopedist I regularly see at work, explaining why it took a nurse a week to believe that her son could have a fracture in his hand.

No harm done (physically, I should say). My son graciously forgives my dismissive diagnosis, but I’m left considering the intersection of mother and nurse, and wondering which part of me I should blame for my error.

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Posted in children's health, nursing perspective, professional identity | Tagged , , , , | 7 Comments »

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Caring for Suicidal Children in the ED

September 1, 2011

By Sylvia Foley, AJN senior editor

Emergency lights #5, by DrStarbuck via Flickr

Suicidal children and adolescents are often first seen in EDs. At Children’s Hospital Boston (CHB) recently, a boy we’ll call J.J. was one of them. Still in elementary school, he had just started a new school year. J.J. has Asperger’s syndrome (a disorder on the autism spectrum), and new situations are difficult for him. His classmates were teasing him, and it was escalating: one boy reportedly threatened to kill J.J. for being “weird.” Despite efforts by J.J.’s parents and the school to address the situation, J.J. became increasingly depressed and fearful. As September CE authors Alexis Schmid and colleagues explain,

On the morning of the ED visit, as the family members were starting their day, J.J. had gone into the kitchen, found a butcher knife, and held it to his throat. His mother walked in and saw him. Although J.J. willingly surrendered the knife to her, she said she was “rattled to the core.”

Schmid was the ED nurse on J.J.’s case that day (all three authors work at CHB). In “Care of the Suicidal Pediatric Patient in the ED: A Case Study,” the authors describe the course of J.J.’s care and what they did to keep J.J., his family, and the hospital staff safe as the day progressed. Read the rest of this entry ?

Posted in audio interviews, children's health, continuing education, nurses, patient safety, practice tips, school nurses | Tagged , , , , , , | Leave a Comment »

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Compassion for Those Among Us: Recent Poems in ‘Art of Nursing’

August 12, 2011

By Sylvia Foley, AJN senior editor

Faded rose texture, by Calsidyrose via Flickr

In Carolyn Scarbrough’s poem “A Rose By Any Other Name” (Art of Nursing, August), a nurse sees an “opaque rose, unfurling” on a CT scan of an infant’s brain. Recognizing this as “evidence of violent acts,” she knows the outcome will almost certainly be tragic. Yet when she looks from the scan to the exhausted young father, another memory shifts her thoughts from “trauma to love.” With each reading, this poem reveals more about the intertwining of outrage and compassion. (Art of Nursing is always free online—just click through to the PDF file.)

“I try / to meditate on emptiness, // receive the next lungful, ignore / my prattling mind,” says the narrator of Risa Denenberg’s poem “Three-Part Breath” (Art of Nursing, July). The poem’s title refers to a yoga breathing practice, one built on trust; as the yoga teacher says, “There will always be // another inhalation.” Read the rest of this entry ?

Posted in art and nursing, children's health, home care nursing, nursing perspective, spirituality and nursing, writing and nursing | Tagged , , , , , | 2 Comments »

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Caught in the Crossfire: The Debt Crisis and a Child’s Shooting in the Bronx

July 29, 2011

By Shawn Kennedy, AJN editor-in-chief—The one good thing about commuting into Manhattan is that I have plenty of time to listen to the news on the radio. This morning, there were two stories that topped local news and gave me food for thought while I negotiated traffic.

One, of course, is the current debacle in Congress over passing a bill to raise the debt ceiling, a necessary move to prevent the country from defaulting on payments. It was expected that a bill put forth by Republicans would have been passed in the House of Representatives on Thursday evening, but Speaker John Boehner did not put the bill forward because he couldn’t garner enough votes from a handful of conservative Republican colleagues who feel the bill doesn’t go far enough in limiting spending and are therefore unwilling to compromise.

What’s ridiculous about all the posturing around this bill is that if it passes in the House, the Democrats in the Senate have already said they will vote it down. So the Republican holdouts aren’t about outcomes, but about appearances. And it’s wasting time we don’t have. As everyone knows by now, a solution needs to happen by August 2. The financial markets have been showing the stress for the last five days (and if you think it doesn’t pertain to you, think retirement accounts, college funds, etc).

And it’s not just the U.S. financial markets—markets around the world are down. Some say that even if Congress does come to its collective sense and pass a bill that will prevent default, the loss of confidence in the stability of our economy has already damaged us in the world market.

The second story reported on the shooting of a five-year-old boy in Bronxdale, which is considered to be one of the safer areas of the Bronx. Apparently the boy was walking with his mother when the firing started, and he was shot in the leg. The news report on the radio said police suspected he was caught in gang crossfire.

I couldn’t help comparing the similarity in the two stories—rival gangs inflicting needless injury while they fight over turf, seeking power, and control. The five-year-old boy and the American people—just collateral damage. The boy, the news said, is expected to fully recover. I wonder if the same can be said for the rest of us.

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Posted in children's health, nursing perspective, Shawn Kennedy, AJN editor-in-chief | Tagged , , , , | 2 Comments »

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