Archive for the ‘Diana Mason, editor-in-chief emeritus’ Category
September 1, 2010
By Shawn Kennedy, AJN interim editor-in-chief
Concussions among young athletes are on the rise—are parents and coaches taking them too lightly?
Photo by Dick Rochester, via Flickr
My sons played ice hockey and football in their high school years, what my husband and I referred to as “collision sports.” The unmistakable sound of helmet-hitting-helmet always made me cringe, especially in hockey where a good skater can generate considerable speed (and therefore force) before impact. I’ve witnessed many players being helped off the ice. The coach, who knew I was a nurse, would sometimes signal to me to come to the bench and check out a player. Most of the time, the player was fine; but there were a few times when it was clear that the player was a bit more than just shaken up.
I recall one 12-year-old who had nystagmus and ringing in his ears and kept asking the same question in a slow, sleepy voice. The coach wanted to put him back out on the ice (“He just saw a few stars, right?”), but instead I sent him with his parents to the ED for evaluation. After an overnight stay in the hospital he was released, but was cautioned not to play hockey for two weeks because he’d suffered a concussion. So he waited two weeks and went back to playing, even though he still had frequent headaches. I also remember a girl who was an excellent high school soccer player. She was hoping to play in college, but by the end of her senior year she’d sustained three concussions and was having cognitive issues—she had trouble working with numbers and suffered headaches. Her neurologist told her she shouldn’t play competitively for at least a year, and perhaps permanently. She was resistant, but her parents enforced the neurologist’s ban. Good for them. Read the rest of this entry ?
Posted in children's health, Diana Mason, editor-in-chief emeritus, nursing perspective, school nurses, Shawn Kennedy, AJN editor-in-chief | Tagged children's health, concussion, school nurses, team sports | Leave a Comment »
July 2, 2010
By Bob Jagendorf/via Flickr
A relaxing and safe Fourth of July weekend from the AJN editors to all nurses in the U.S., whether you’re taking it easy or on the job!
A recent poll conducted by the Kaiser Family Foundation shows rising popularity for the health care reform law. Many hard decisions still need to be made; innovation is more crucial than ever. Nurses who’d like a clearer sense of how the health care reform law may affect them in the coming years should have a look at “Health Care Reform: What’s In It for Nursing?” in our July edition. Written by AJN‘s emeritus editor-in-chief Diana Mason, it points out some of the new models of care the law promotes, models in which nurses play an increasingly important and vital role at every level. As often in the dynamic history of this country, there will be new kinds of opportunities for those who are ready for them.—JM, blog editor
Posted in Diana Mason, editor-in-chief emeritus, health care reform, nursing perspective, professional identity | Tagged HCR, health care reform, innovation, medical homes, nurses | 1 Comment »
March 18, 2010
By Shawn Kennedy, MA, RN, AJN interim editor-in-chief
On a new post at Homeland Voice, author Fiona Regina, MSN, RN, presents a rather critical discussion of the American Nurses Association’s opposition to the National Nurse initiative. She writes, “For heaven’s sake, it’s time for the ANA to get on board. The entire ANA organization would be better served by embracing motivated, politically active nurses willing to improve the health of our nation.”
Regina offers several theories as to why the ANA might be taking the position (that is, aside from their stated reasons, one of which is that the U.S. Public Health Service already has a Chief Nursing Officer); what’s lacking in her piece, though, is any comment from the ANA to refute her charges or further elucidate their position.
The ANA stance aside, the notion of a National Nurse keeps coming up and has support from many sectors. Diana Mason, AJN‘s editor-in-chief emeritus, argued for it here last September. More nurses should join the debate so that this issue can either move forward or be put to rest. What’s your opinion?
Posted in advocacy/political action, Diana Mason, editor-in-chief emeritus, nursing perspective, professional identity, Shawn Kennedy, AJN editor-in-chief | Tagged ANA, national nurse | 28 Comments »
December 11, 2009
Photo from otisarchives4, via Flickr
By Diana J. Mason, PhD, RN, FAAN, editor-in-chief emeritus of AJN. Mason is a member of the National Advisory Committee of Kaiser Health News.
I was delighted to see Kaiser Health News publish a superb commentary by nurse researcher Mary Naylor and health economist Mark Pauly on why nurses are the key to patient safety and quality, the barriers that interfere with nurses being these sentinels, and what can be done to address these barriers. It should be required reading by all policymakers, CEOs of health care organizations, and trustees.
Posted in Diana Mason, editor-in-chief emeritus, nursing innovations, nursing perspective, nursing research, professional identity | Tagged champions, nurses, patient safety | 1 Comment »
November 20, 2009
by sunsets_for_you/via Flickr
By Jacob Molyneux, senior editor/blog editor
Diana Mason, AJN‘s emeritus editor-in-chief, posted here on the new U.S. Preventive Services Task Force mammography recommendations earlier this week, noting some troubling questions AJN had raised years ago about how much evidence actually supports the wholesale acceptance of yearly screening for women age 40 and older.
But we know that the bottom line for many American women remains this: “Are you really telling me that it’s better not to know as early as possible that I might have cancer? You must be kidding!” After all, we’ve all heard of someone whose life may have been saved by the early detection provided by a mammogram or a breast self-exam.
What about the other side of the experiential coin? Forget the evidence for a minute. Let’s not talk about the fact that, as Maryann Napoli pointed out in AJN in 2004, the “technology leads to the unnecessary treatment of some cancers that might have remained latent, and it also detects invasive breast cancers so slow-growing that women will have long lives regardless of when tumors are found.” That’s what the science may be telling us. That’s for the number crunchers.
What we want to know is more basic: have you or your patients ever experienced real suffering and anxiety from a false positive result, or negative consequences from treatments that you may now believe to have been unnecessary? Is there really anything to this concern—and will it ever be enough to convince women without significant risk factors for breast cancer that it might actually be better to wait for that mammogram?
(For some illuminating historical perspective on the topic, see the Op-Ed piece in today’s NY Times, Addicted to Mammograms.)
Posted in Diana Mason, editor-in-chief emeritus | Tagged guidelines, mammograms, mammography, USPSTF | 4 Comments »
November 17, 2009
Diana J. Mason, PhD, RN, AJN editor-in-chief emeritus
By jared, via Flickr (creative commons)
Exactly what is the evidence supporting annual mammography screening and breast self-examination for women over the age of 40?
The U. S. Preventive Services Task Force (USPSTF) conducted a systematic review of this issue and concluded that the evidence for mammography screening of women before the age of 50 years is equivocal and the evidence for breast self-examination is inconclusive. The report notes that the Task Force reached a different conclusion about the quality of the studies on mammography than did a Cochrane Collaboration review done in 2001, with the Cochrane review having much less confidence in the quality of the available research
In April 2001 and January 2004, AJN published two controversial commentaries on the topic by Maryann Napoli, a member of the AJN editorial board and deputy director of the Center for Medical Consumers. Napoli pointed out that the available evidence from large international studies didn’t support the belief that early detection of breast cancer actually resulted in lower mortality rates and that the high number of false positive tests resulted in unnecessary anxiety and treatment. At the time, there was even some evidence that premenopausal women who are diagnosed with breast cancer through mammography may actually die earlier than women who are not screened. More recently Napoli has been updating her thoughts on mammography screening in response to new research (but not yet the USPSTF guidelines) at her center’s Web site.
Breast cancer is a leading cause of death among women, but we can’t assume that early screening will save lives. As we discovered with prostate cancer, some cancers simply won’t be eliminated by any treatments we have available, and we need a more critical examination of the potential adverse effects of all those biopsies.
Maybe the new emphasis on the importance of comparative effectiveness research for measuring quality and controlling costs might help us to design studies that will provide stronger evidence for the proper place of mammography and breast self-examination for reducing the number of deaths from breast cancer.
Posted in Diana Mason, editor-in-chief emeritus, health care reform | Tagged breast cancer screening, comparative effectiveness research, mammography, SBE, USPSTF guidelines | 2 Comments »
October 21, 2009
UK National DNA Infographic/ by blprnt_van, via Flickr Creative Commons
By Diana J. Mason, PhD, RN, editor-in-chief emeritus. Mason often writes for this blog about policy and research issues.
Last week, I attended the annual conference of CANS, the Council for the Advancement of Nursing Science, the “research-facilitation arm” of the American Academy of Nursing. The title of the conference was “Technology, Genetics and Beyond: Research Methodologies of the Future.”
‘Genomics’ vs. ‘genetics.’ I’m not a genomics researcher but I found the sessions enlightening in two ways. First, I admit to struggling with the terminology (and jargon) of the field. I was reminded today that the correct term for the field is “genomics,” since “genetics” refers to the study of single genes and thus limits the focus of study mostly to rare diseases. Genomics looks at associations among genes in the whole person—a shift in perspective that was enabled by the mapping of the human genome.
Targeted interventions. The second enlightenment came from keynote speaker and senior nurse researcher Christine Miaskowski, a dean and a professor of physiological nursing at the University of California at San Francisco School of Nursing. She noted that this shift to a focus on the whole person is what makes nurses and nursing research essential to the field. She gave an example from her own research looking at fatigue among people with cancer. When all patients are grouped together, it looks as if there is little variation across time. But when you diagram each patient’s changes in levels of fatigue, there is actually huge variation. By looking at the genetic composition of individual patients, she’s been able to determine who might respond best to a specific intervention that appears to have no effect when all patients are considered together. Such close examination of patient characteristics can help nurses and other health care providers to better tailor their interventions for the individual patient.
Ethical issues in research. That said, Suzanne Feetham, a nurse who has been a leader in advancing health care professionals’ understanding of genetics and genomics, talked about the ethical issues involved in conducting such research. Read the rest of this entry ?
Posted in Diana Mason, editor-in-chief emeritus, ethical issues, nursing innovations, nursing perspective, nursing research | Tagged American Academy of Nursing, cystic fibrosis, end of life care, ethics, genetics, genomics, mapping, National Institute for Nursing Research, NIH, nursing research, point-of-living research, underfunded | Leave a Comment »
October 20, 2009
By Diana J. Mason, PhD, RN, AJN Editor-in-Chief Emeritus
November 2009 report cover
What makes a “good hospital”? A patient might have the best surgeon in the world; but as any nurse will tell you, that patient will die unless the surgeon has a top-notch nursing staff to ensure that the patient is well prepared for the surgery and well supported during the recovery period. Too many hospitals have lost their understanding of what’s essential to ensure great clinical and financial outcomes. In such hospitals, nurses aren’t included in decision making, have little local authority, are penalized for identifying factors that lead to poor care, and can’t claim excellent team relationships.
The American Nurses Credentialing Center’s Magnet Recognition Program has helped to identify the factors that lead to excellence in nursing care, granting Magnet status to hospitals that provide such excellence. Now an initiative known as Transforming Care at the Bedside (TCAB) has provided the framework and tools for empowering bedside nurses to become agents for change. TCAB nurses work with other health care team members to improve care processes and effectiveness, focusing on four areas: the safety and reliability of care, teamwork and job satisfaction, patient and family satisfaction, and “value-added care.” (Increasing the amount of time nurses can spend with patients by decreasing the time they must spend charting or hunting for supplies would be one example of adding value to care.)
In November AJN is publishing a special report, Transforming Care At the Bedside: Paving the Way for Change, with the support of a grant from the Robert Wood Johnson Foundation (RWJF); it’s available online now. Read the rest of this entry ?
Posted in Diana Mason, editor-in-chief emeritus, nursing innovations, nursing perspective, nursing research | Tagged hospital quality, patient safety, quality of care, TCAB | Leave a Comment »
October 6, 2009
By Shawn Kennedy, MA, RN, AJN interim editor-in-chief
At the AJN Conference: left to right, Diana Mason, Amanda Stefancyk, Catherine Drous, Teresa Pavone
Speaking Sunday night at the first AJN Conference in Chicago, Diana Mason, AJN’s editor-in-chief emeritus, told the audience about her recent visit to the West Wing of the White House. If you watched the news that week you may have seen President Obama’s declaration to a crowd of nurses: “I love nurses.”
Mason told the conference that she was disappointed in the remark because “that’s not what nurses need.” Nurses need to be respected for what they know and for what they do, and then they need to be given a seat at the policy table when strategies for changing the health care system are being discussed.
Right now, she said, “no one is paying attention to the nurse-led models of care that work.” These include the American Academy of Nursing’s Raise the Voice Campaign; the AARP/Robert Wood Johnson Foundation Center to Champion Nursing in America; the Initiative on the Future of Nursing; and Transforming Care at the Bedside (TCAB), the collaborative initiative of the Robert Wood Johnson Foundation and the Institute of Healthcare Improvement. Read the rest of this entry ?
Posted in Diana Mason, editor-in-chief emeritus, health care reform, media depictions of nursing, nursing innovations, nursing perspective, professional identity, Uncategorized | Tagged Diana Mason, health care costs, health care reform, hospital quality, nurses, Obama, patient safety, quality improvement, quality of care, White House | 3 Comments »
September 21, 2009
By Diana Mason, editor-in-chief emeritus
Ann Keen
First, the necessary throat-clearing about who and where: I recently attended a public session held by the Institute of Medicine Initiative on the Future of Nursing. Chaired by University of Miami president and former secretary of Health and Human Services Donna Shalala and chief nurse for Cedar Sinai Medical Center Linda Burnes Bolton, the session began with presentations by two nurses involved in the Prime Minister’s Commission on the Future of Nursing and Midwifery in England: Ann Keen, Member of Parliament and Parliamentary Undersecretary for Health Services, who chairs the British commission; and Jane Salvage, the lead secretariat for the commission and a former contributing editor for AJN.
Now the point: During the formal session, Keen noted that various countries in the UK each have a chief nurse officer (CNO) who is responsible for developing a national nursing strategy. Afterwards, I interviewed Keen and Salvage, who both said they didn’t understand why American nurses were not supporting the call for a CNO for the United States, one who would be charged with developing and overseeing a national nursing strategy for this nation. In their eyes, a CNO who is on par with the surgeon general could help the nation to develop approaches to ensure an adequate nursing workforce, identify barriers to their full utilization, identify new models of care to better promote the health of the public, and develop strategies for removing the barriers that impede forward movement.
Opposition from nursing groups. In the U.S., organized nursing has largely opposed the efforts of a group of grassroots nurses who are calling for the establishment of an Office of the National Nurse. Read the rest of this entry ?
Posted in Diana Mason, editor-in-chief emeritus, health care reform, international nursing, nursing perspective, nursing shortage, professional identity | Tagged CNO, Donna Shalala, IOM, national nurse | 21 Comments »
