As with Ebola Outbreak, Social Determinants of Health Crucial in Recent Rural U.S. HIV Outbreak

Rachel Parrill, PhD, RN, APHN-BC, is an associate professor of nursing at Cedarville University in Ohio

by banditob/flickr creative commons by banditob/flickr creative commons

This past fall, with the world watching, a crisis unfolded in West Africa that challenged our understanding of sociocultural environments, epidemiology, and health. The spread of Ebola and the intercontinental transmission of the disease exposed weaknesses in our epidemiological defense system. It also drew attention to the powerful role that cultural beliefs and practices can have on disease transmission during outbreaks.

In that same time frame, and with similar cultural etiologies, another infectious crisis played out much closer to home. The setting: the rural Midwest, in and around the small town of Austin, Indiana. The disease: HIV. The crisis: an unprecedented outbreak—one with incidence rates (up to 22 new cases a day at the height of the outbreak) estimated to be higher than those in many sub-Saharan African nations and transmission rates through injection drug use higher than in New York City. Contributing to this “perfect storm” were socioeconomic factors characteristic of many rural settings, including poverty, low education levels, limited access to health care, and few recreational or employment opportunities.

In my work as a faculty member in a rural Midwest setting, I introduce undergraduate and graduate nursing students to concepts of public health nursing and try to provide […]

Hepatitis A, B, and C: The Latest on Screening, Epidemiology, Prevention, Treatments

One of several posters created by the Centers for Disease Control and Prevention to raise awareness that millions of Americans of all ages, races, and ethnicities have hepatitis C—and many don’t know it. Posters are available to order or download for printing at www.cdc.gov/knowmorehepatitis/media/posters.htm. Poster © Centers for Disease Control and Prevention. One of several CDC posters intended to raise awareness that millions of Americans of all ages, races, and ethnicities have hepatitis C—and many don’t know it. Posters are available to order or download for printing at www.cdc.gov/knowmorehepatitis/media/posters.htm. Poster © Centers for Disease Control and Prevention.

It’s crucial that nurses in all health care settings stay informed about the changing landscape of viral hepatitis in the United States. Hepatitis affects the lives of millions, too many of whom are unaware that they have been infected.

Right now, there’s good news and bad news about hepatitis in the U.S. While the incidences of hepatitis A and B in the United States have declined significantly in the past 15 years, the incidence of hepatitis C […]

Redeemed by M*A*S*H

Greg Horton is a widely published freelance writer and an adjunct professor at Oklahoma City Community College. With a new generation of veterans struggling to deal with emotional and physical wounds from their experiences in Iraq and Afghanistan, and to find meaningful work in a challenging economy, this story of a father’s 30-year nursing career after his return from the Vietnam War is particularly relevant today.

MASH-dioramaMy father started us on M*A*S*H soon after his return from Korea in 1973. The Vietnam War was nearing its end, although we did not know it at the time. A combat medic during his tour of duty in Vietnam early in the war, on this most recent tour my father had been stationed in Korea for a year at a hospital that received the grievously injured. “Spaghetti and meatball surgery,” he called it.

Our family had moved to Maud, Oklahoma, in 1972 to be near my mother’s family while my dad was in Korea. The endless countryside around our small town, combined with the local dump, gave us more than enough adventures to keep our minds off the war in a country of which we knew little.

M*A*S*H, the legendary television show featuring Alan Alda as the sarcastic antihero, started the year my father left for Korea. We were not a television-watching family, as such. My mother’s Pentecostal background instilled a deep-rooted distrust for the medium, unless Oral Roberts or Rex Humbard was preaching.

However, on my […]

When a Fellow Nurse Abuses Drugs on the Job

. . . the nurse wasn’t anywhere on the floor. I started looking around, asking other nurses. My frustration grew when I realized that something about the entire floor felt wrong. The entire night shift had disappeared. My chest tightened and I started to worry about what had happened at the hospital last night.

That’s a short excerpt from the Reflections essay in the October issue of AJN, “A Good Nurse.” It’s by oncology nurse Theresa Brown, who happens to also have a new column out this week at the New York Times Opinionator blog. Never one to shy away from sensitive topics, in this essay she takes on the shock and betrayal in learning a fellow nurse has been abusing drugs on the job. Click the link above or the image on the right to read the whole short essay (click through to the PDF version for the best reading experience). We welcome your responses here, of course.—Jacob Molyneux, senior editor
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