Archive for the ‘public health nursing’ Category

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Children, Swimming Pools, and Preventing Death by Drowning

July 20, 2011
A boy in a children's swimming pool.

Boy in children's swimming pool/image via Wikipedia

By Shawn Kennedy, AJN editor-in-chief—Most children love water, from splashing in puddles to throwing rocks into streams to just playing in the bathtub (a favorite activity of one of my boys was to stand on a chair at the kitchen sink and “wash dishes” with mounds of bubbles). Keeping them away from potentially dangerous situations around water requires constant vigilance when they’re young and repeated warnings as they get older. But often that’s not enough. Too many children drown or nearly drown each year in backyard swimming pools. U. S. Centers for Disease Control and Prevention data shows drowning as the second leading cause of death from unintentional injuries among children ages one to 14.

Last Friday, there was an especially heart-wrenching story: one-year-old twin boys both drowned in a backyard pool in Northern California. Their mother found them, pulled them out of the pool, and tried to revive them but was unsuccessful. I can’t imagine the depths of her grief.

We tend to think that it’s only the large, in-ground swimming pools that pose a hazard. But a recent study in Pediatrics documents that danger persists for all pools, including small backyard portable pools (wading pools, inflatable pools, soft-sided pop-up pools, etc). It looked at drowning and near-drowning (“submersion events”) in these types of pools from 2001 to 2009 and tallied 209 drownings and 35 near-drownings among children under 12.

Not surprisingly, the majority occurred in younger children: 94% were children under five; more than half were boys. And 73% happened in the child’s own backyard. While the description of the type of pool was only reported in about a third of the cases, 41% of the described pools were described as “wading pools.” The authors call for a consumer-education campaign “to make consumers aware of the dangers of portable pools because these small, inexpensive, consumer-installed pools may not generate the same sense of risk as an in-ground pool. “

This study serves as a reminder to parents and grandparents and anyone who cares for children that any body of water—including two inches in a bathtub, a low toilet, or the ankle-deep water at the ocean’s edge—can be dangerous, depending on the age of the child.

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Sexual Predators Online: Where Do They Intersect With Adolescents and Young Adults?

June 30, 2011

Here are some of the results described in “Online Social Networking Patterns Among Adolescents, Young Adults, and Sexual Offenders,” an original research article published in the July issue of AJN:

nearly two-thirds of Internet offenders said they’d initiated the topic of sex in their first chat session; more than half . . . disguised their identity when online; most . . . preferred communicating with teenage girls rather than teenage boys; high school students’ experience with “sexting” . . . differed significantly according to their sex; a small number of students are being threatened and assaulted by people they meet online; avatar sites such as Second Life were used both by students and offenders . .  . .

What’s your own experience? Have a look at the article, and pass along the link if you find it useful, as a parent or nurse. Have you heard any concerns about Internet safety from parents or adolescents you encounter in your own practice or community? What’s your own take on Facebook and privacy, or any other issue raised in this article?—JM, senior editor

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Making Homes Safer

June 20, 2011

By Shawn Kennedy, AJN editor-in-chiefThe Canadian Partnership for Children’s Health and Environment suggests five actions for parents to follow to reduce their children’s exposure to environmental hazards at home. While the recommendations are not really new, it’s worth reminding parents of young children and women who are pregnant or contemplating pregnancy to be mindful of potential hazards from common household substances. Here are the recommendations (you can download the free brochure):

  1. Minimize dust in the air (which may contain minute lead particles) by frequent vacuuming and by using a damp cloth when cleaning.
  1. Use nontoxic cleaners (baking soda or vinegar and water are recommended as ‘green’ cleaners, and a number of commercial products without harmful chemicals are now available) and avoid antibacterial soap and items with added fragrances to minimize exposure to chemicals.
  1. Seal off areas undergoing renovation to avoid dust and fumes. Caution women who are pregnant and young children to avoid the area.
  1. Minimize exposure to plastic to avoid exposures to bisphenol A (BPA) and polyvinyl chloride (PVC). Avoid storing food in plastic (glass or ceramics are recommended) or microwaving food that’s in plastic containers or covered with plastic wrap; discard soft plastic toys that contain vinyl or PVC that might be used by or come into contact with infants and children.
  1. To minimize exposure to mercury, be mindful of the kind of fish you eat and how often you eat it.

Also, see “Best Practices in Environmental Health” in our June 2009 issue.

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Tragedy into Policy: A Hepatitis C Outbreak and a Study of Nevada RNs Lead to New Protections for Whistleblowers

June 7, 2011

By Sylvia Foley, AJN senior editor

In 2008, more than 62,000 people who had undergone procedures at one of two southern Nevada endoscopy clinics were notified that “they might have been exposed to bloodborne pathogens, including hepatitis B virus, hepatitis C virus (HCV), and HIV, as a result of unsafe injection practices.” As author Lisa Black reports in this month’s CE–Original Research feature, a subsequent investigation by federal and state agencies found multiple breaches of infection control protocols. Indeed, 115 patients were found to be “either certainly or presumptively infected” with HCV through the reuse of contaminated medication vials.

Especially distressing was strong anecdotal evidence that because of a general fear of workplace retaliation, staff at the two clinics had often failed to report unsafe patient care conditions. At the request of the Nevada legislature, a study was conducted to examine Nevada RNs’ experiences with workplace attitudes toward patient advocacy activities. Black was the principal investigator. Read the rest of this entry ?

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A Primary Source Reminder from the Early Days of HIV/AIDS

June 6, 2011

By Maureen Shawn Kennedy, AJN editor-in-chief

Last week, I received a press release from the National Institutes of Health noting the publication 30 years ago of the first ‘official’ report that many consider to have heralded the beginning of the AIDS epidemic—a report in the MMWR (Morbidity and Mortality Weekly Report), a publication of the Centers for Disease Control and Prevention (CDC), about cases of Pneumocystis carinii pneumonia and Kaposi’s sarcoma in otherwise healthy young men who all happened to be gay.

This report (which included various causative theories, including speculation that the weakened immune system among these gay men might somehow have resulted from the use of lifestyle drugs such as amyl nitrate!), seemed late in coming for those of us who’d been seeing unusual infections among gay men since the mid-1970s.

In 1975, I became aware of these young men when they started coming for diagnostic consultation with the physicians I worked with in a private hematology–oncology practice in New York City. No one could figure out why they had developed opportunistic infections that were normally seen only in patients who’d been on chemotherapy or who had other immune disorders. We talked about the fact that similar cases were being seen at the (now defunct) St. Vincent’s Medical Center in Greenwich Village. Read the rest of this entry ?

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Abandonment Guilt

May 16, 2011

This is the last in a series of posts by Sue Hassmiller, who has been blogging from the tornado destruction in Alabama, where she’s been volunteering with the Red Cross.—JM, senior editor/blog editor

I will do hospital visits today and have been told that the first family I will visit is a priority—an 8-year-old is not expected to make it through the day.  If he dies, then he will join his mother and brother, who were killed instantly. The father, who was at work when the tornado hit, was spared. We will talk to the father or the uncle. He speaks Spanish, so a translator will be present. 

"Home Is Where the Heart Is"

How do you convey in words—especially through a translator—what you need to say, what you want to say? I will hug him . . . I know I will . . . everybody hugs here. And I know there will be survivor’s guilt. Not being a war veteran, this is the closest I have been to so much of it: a grandfather who survived while holding his 7-week-old granddaughter, who was “swept up and away”; an elderly mother who lost her 42-year-old daughter (a “famous paramedic . . . and helping so many”);  a wife of 32 years who lost her husband, the only breadwinner for the family—it goes on and on. 

The stories fill large white notebooks now, here at headquarters in Birmingham. And I am leaving tomorrow. I am leaving all of this behind and feel very acutely that I am abandoning them, all of them. I know better, know in my head that life will go on, that I must return to work, that I have a very loving and supportive husband waiting for me, that I have a dog that has not been “properly” walked for the last 11 days. But my heart is still suffering today. I will follow the advice that I gave a colleague yesterday morning when she conveyed her own sense of abandonment guilt. I told her, “Becky, this is only half your job. The other half is going home and continuing to tell the stories of the people of Alabama and how the Red Cross helped them.” 

I also told her that ”there will always be disasters, and as long as there is a Red Cross (and many other wonderful organizations), then hope lives.” I believe that in my head—it will just take a bit longer for my heart to catch up.

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Meeting Nightingale in Alabama; Where Were the Young Nurses? Further Notes from the Disaster Zone

May 13, 2011

Sue Hassmiller has been blogging from the tornado-damaged area in Alabama, where she’s volunteering for the Red Cross. This and all other posts in this series are collected on a separate page for easy reference.—JM, senior editor/blog editor

Finishing up some very difficult hospital visits with victims and family members at the University of Alabama–Birmingham Medical Center today, I saw the sign for the school of nursing. I remembered Dean Dodi Harper telling me last year of a man who had donated to her school what might be the largest grouping of original Florence Nightingale letters. A priceless gift indeed! Her intent was to transcribe the letters and eventually have an exhibit. As I saw the School of Nursing sign, the conversation all came back to me . . . and then I realized it was May 12, Nightingale’s actual birthday, the day we celebrate Nurses Day! Too good to be true: I e-mailed the dean and got an immediate response (I love those type A personalities!). She was away, but the assistant dean for clinical affairs and partnerships, Cindy Selleck, would welcome me—and indeed on this occasion the letters were on display in a temporary exhibit. Having been on a special Nightingale tour last year to England and Istanbul/Scutari, the words of this great mentor had taken on a whole new meaning for me (here’s the blog series I wrote at the time). 

Seeing this very special exhibit and Nightingale’s words on her very own stationery made me realize once again why I had come to Alabama. Between the families that we helped that day and Nightingale’s words of inspiration, this is a Nurses Day I will never forget. Happy Nurses Day all! It was a great one for me!            

Where were you, my young colleagues? Looking around at who served in this disaster gave me a stark reminder of the great need to replenish our ranks. Most nurses were my age and older, a well-experienced corps to be sure, but this just won’t do for the future!! Students ask for advice all the time about how to go about finding a job when there are few jobs currently to be had. And this is what I tell them: 

Red Cross Student Nurse Guidelines

1). Take any job that is available and move on from there.

2). If possible, take this time to continue your education. Getting the vast majority of nurses (80%) to the BSN level by 2020 is a big goal of our Future of Nursing: Campaign for Action.

3). VOLUNTEER. Doing volunteer work can help you get a broad base of experience you could not otherwise get. That’s how I started my career. It was always the Red Cross, but it was also free care medical clinics, children’s medical services, and several years as a camp nurse for diabetic children. I realize that there are rent and student loans to repay, but doing something to expand your resume for even two hours a weeks will benefit you immensely. For more information on the Red Cross go to this page and this page. Your professional associations, like the American Nurses Association, and especially the National Student Nurses Association while you are still in school, are also good places to connect.

The next time I volunteer to serve in a disaster, I want to see you there! Please!

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Pay It Forward: A Meditation on Suffering, Volunteer Work, and Storytelling

May 12, 2011

Sue Hassmiller has been blogging from the tornado-damaged area in Alabama, where she’s volunteering for the Red Cross. This and all other posts in this series are collected on a separate page for easy reference.—JM, senior editor/blog editor

What an honor and privilege it is to help another human being—that’s how we all feel being here. There is no greater gift. Period. And we love to share our stories—including those that break our heart, especially those that break our heart. That’s what we do: we do our work and then we share our stories—our therapy, if you will. And we’re like kids at Christmas with what we are able to do for people, comparing the gifts we were able to give and reactions to those gifts. 

Today, because of the gift of money from Red Cross donors, I was able to take an inconsolable 21-year-old, who was swept up into the sky holding onto her baby for dear life, whose hard landing back to the ground caused six broken ribs,  a torn knee, a black eye, and a broken collarbone—and now pneumonia—and provide her with a doctor’s visit, filled prescriptions, food, and gas money to get to her doctor’s appointments and pick up her baby (who is doing well) from her boyfriend’s house many miles away. These are all the things we take for granted, but for her, on this day, luxuries.  Read the rest of this entry ?

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‘Today I Cried’: A Family’s Loyalty, A Veteran’s Lost K-9 Helper

May 11, 2011

Sue Hassmiller has been blogging from the tornado-damaged area in Alabama, where she’s volunteering for the Red Cross. This and all other posts in this series are being collected on a separate page for easy reference.—JM, senior editor/blog editor

Today I cried.

Although I’ve seen horrific things and heard the worst stories imaginable here in Alabama, it was not until today that I cried. It had to do with my soft spot for daughters and dogs. 

The daughter. My morning visit was to a 50-year-old woman, Kate (not her real name), in the most rural of rural Alabama. Our team went to see her because she had lost not one family member, but three: her mother, her sister, and her brother. Kate told us that her mother and sister wouldn’t leave her wheelchair-bound, 6’ 4” brother for shelter. They didn’t have the strength to move him, so they simply sat with him in the living room and prayed for the best. She later found them in the field, with her sister still holding her brother in her arms.  Read the rest of this entry ?

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Unheeded Warnings, Last Words, the Value of a Bathtub: More Notes from Alabama

May 10, 2011

Sue Hassmiller, the Robert Wood Johnson Foundation Senior Adviser for Nursing, has been blogging from the tornado-damaged area in Alabama. This post elucidates some of the philosophic and strategic context for the emotionally challenging Red Cross volunteer work she’s currently involved in. This and all previous posts in this series are being collected on a separate page for easy reference.—JM, senior editor/blog editor

The author in Alabama house ruin

Human Caring
It amazes me how much compassion there really is in the world. You don’t always see it day to day, but during disasters it’s the definitive order of the day. It is so refreshing to be a volunteer in this temporary health care structure we are working in and not have to worry about 10-minute office visits or rushing in and out of patients’ rooms trying to get it all done before the bell rings for the day. The Red Cross simply (with guidelines, of course) directs us to attend to all human needs (ok, yes, we do have forms to fill out). Therefore, a visit to a distraught family could take 10 minutes, 10 hours, or 10 months.

The devastation is so great here that as long as there are people to volunteer and the financial resources to carry on, this job will go on for years. A few of the groups that are here besides the Red Cross include the NAACP, Southern Baptist Convention (see today’s NY Times story on their role), Habitat for Humanity, Islamic Relief, and many more. The tapestry is among the most beautiful I have seen. Death and destruction are everywhere, but the compassionate spirit of humanity reigns supreme!

Sleuthing
Today’s assignment took my seven-person team on a two-hour drive from Birmingham to the counties of Franklin and Marion in the northwest corner of Alabama. This is a hard-hit area. The charge was to assist the families of the deceased and injured in any way we could. The target was hospitals, the coroner’s office, FEMA, and the county emergency director: find the people and start helping them! Read the rest of this entry ?

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