Posts Tagged ‘nurses’

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Women’s Health Week – It’s Your Time

May 16, 2012

Cycling mother and daughter, Netherlands/via Wikimedia Commons

Women, especially working women with families, often are their own last priority—the job and family come first. This week is the 13th annual National Women’s Health Week, which started on Mother’s Day, May 13, and will last until May 19th. The theme for this year is “It’s Your Time.” And it’s the perfect time for women to stop and take stock of their own health needs. This year’s Women’s Health Week is particularly poignant, coming on the tail of the recent debates about access to birth control on the national stage.

Coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health, this special week is meant to bring together health organizations, businesses, government offices, and communities in order to promote women’s health. You can find more information about how to get involved on womenshealth.gov.

Our views on women’s health continue to evolve. For example, menopause: what is a “normal” symptom during menopause? What treatments are available for various symptoms, and what can women do to help themselves? What do we currently know about the effects of certain treatments, and are they worth the possible benefits? Are we overmedicalizing women’s bodies? Or what about pregnant nurses on the job? What might endanger their health or that of their developing babies?

We’d like to offer some of our recent articles on women’s health to help increase awareness of some health issues:

“Menopausal Hormone Therapy: What We Know Now,” by AJN clinical managing editor, Karen Roush. Part I of a four-part series on postmenopausal health.

“Prevention and Treatment of Osteoporosis in Postmenopausal Women: A Review.” Part II of series.

“The Underutilization of Emergency Contraception”

“Occupational Hazards for Pregnant Nurses”

Also note part III of our ongoing series on postmenopausal health: “Managing Menopausal Symptoms.” This publish-ahead-of-print CE (available for a short time now if you click through to the PDF version, and slated to appear in the June issue of AJN), provides a useful review of the three most commonly reported symptoms of menopause: hot flashes, insomnia, and mood problems.—Michael Fergenson, senior editorial coordinator; Shawn Kennedy, editor-in-chief; Jacob Molyneux, senior editor/blog editor


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Books or e-Books: How Do You Read?

April 24, 2012

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

AJN iPad app display

I just finished reading a report, released earlier this month from the Pew Research Center, on the rise of e-reading—whether on e-book readers like Kindles and Nooks; tablet devices like iPads; cell phones; or computers. The report details the results of surveys of nearly 3,000 adults ages 16 years and older conducted in December, 2011, and then again in February, 2012, about their reading habits.

Prior to the 2011 holiday season, approximately 17% of adults had read an e-book in the previous year, but in the post-holiday survey early the next year, following holiday gift giving, that number had jumped to 21%. While printed books still dominate (in December, 2011, 72% of Americans reported that they had read a printed book in the past 12 months), e-reading is growing more popular. And it seems that those who read e-books are spending more time reading “since the advent of e-content”: in particular, 41% of tablet owners and 35% of e-reading device owners say they are reading more now.

Format follows function. One question asked in the December 2011 survey was which format was better for a variety of reading situations. E-books scored slightly higher than print books for reading in bed (45% vs 43%), but considerably higher for reading while traveling or commuting (73% vs 19%), availability of broad selection of content (53% vs 35%), and “being able to get a book quickly” (83% vs 13%). I concur on all points. (Reading with a child and sharing books with others were notable exceptions, with traditional print books still highly favored for these activities.)

I wasn’t especially keen on getting an e-reading device, but my family gave me one as a gift. It proved itself when snowstorms left me stranded in Puerto Rico while I was on a winter vacation (see my blog post). The hotel’s paperback supply quickly became depleted. However, with my trusty Kindle, I just downloaded more reading material.

I love the portability of having scores of books at my disposal—and the option to get just about anything else I want, from newspapers to journals. Now, I take my iPad, which has a Kindle app that allows me to access books I downloaded on that device; it’s also backlit, which means I don’t have to keep a light on if I read in bed. I only take my Kindle if I plan to read on a beach, since it’s not backlit and doesn’t have any glare.

AJN now has an iPad app and many journals are developing them as well (we hope to eventually have applications to fit other e-reading devices too). I’m wondering—are many of you, our readers, reading e-books? Are you using the iPad, or do you prefer computers (used by a surprisingly high percentage of survey respondents), Kindles, Nooks, or other devices? We’d love to hear how you’re reading.

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Posted in Shawn Kennedy, AJN editor-in-chief | Tagged , , , , , , , | 3 Comments »

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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. Read the rest of this entry ?

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April Apps and Other Good Things

April 4, 2012

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

April is one of those months most people like, I think—the weather becomes consistently warmer and flowers appear. And this month, we at AJN are especially delighted because we launch our very own iPad app! As a temporary introductory offer, you can download the app for free (click here, or search under American Journal of Nursing in the iTunes app store) and get the full April issue. (Eventual pricing is still being determined.)

It’s another way AJN is providing you with accurate, evidence-based information in formats that allow you to access it when and where and how you want it. Don’t forget to subscribe to our always free audio podcasts, too—there are monthly highlights and interviews with authors.

And April is a stellar issue. This month we focus on examining how we treat people with disabilities. The cover, the editorial, and two features all deal with how we need to do better in this area. In the original research article, Suzanne Smeltzer and colleagues report on their survey of people with disabilities, querying them on interactions with nurses during hospitalizations. Their findings are sobering and should serve as a wake-up call when providing care to people with disabilities when they are hospitalized.

There’s also a poignant piece, “Hard Lessons from a Long Hospital Stay,” describing the experience of one of the authors of the research article, Michael Ogg, who despite being severely disabled from multiple sclerosis, lives independently. Yet during his four hospitalizations, he was mostly bedridden, unshaven, and often left unfed because the system is not geared towards people with disabilities nor are nurses familiar with providing care for them.

I hope these articles will increase awareness and spur some changes in how hospital-based nurses view and interact with people with disabilities (and also among faculty who are developing curricula). There’s also an interview with the authors of these pieces—just click on the podcast icon when reading the article on our Web page (or tap the icon when on the iPad).

‘Course, there’s also another CE article in the issue, articles dealing with latent tuberculosis in health care workers, managing cancer fatigue, a QI report on early post-op ambulation, news, Drug Watch, the Reflections essay, Art of Nursing, and more. You can go right to the issue on our Web site, or download the app and check it out on your iPad (the graphics are awesome!), or  of course read it in print—your choice on how you want to keep up to date.

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Posted in nursing perspective, nursing research, patient perspective, Shawn Kennedy, AJN editor-in-chief | Tagged , , , , , | Leave a Comment »

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Examining Our Biases About Mental Illness

February 24, 2012

“There’s nothing really wrong with him, it’s just anxiety.” How many times have you heard someone say this—or said it yourself? Mental health problems are among the most marginalized health conditions in the United States. They’re viewed as less “real” than physical illnesses; there’s no tumor to be palpated, no abnormality to be spotted on an X-ray. Emotional and psychological problems are often thought to be under a person’s control in a way that, say, multiple sclerosis or cancer is not. And because mental health problems can be construed as signs of weakness, sufferers may hide their symptoms. People who suffer from a mental illness need to feel comfortable seeking care and to trust that they’ll be treated with skill, compassion, and respect. This is vital: studies consistently find that mental illnesses, particularly depression, take a terrible toll on health. Such illnesses have been associated with an increased risk of stroke, coronary artery disease, and dementia, as well as increased mortality in people with cancer, diabetes, or chronic kidney disease and following a myocardial infarction or coronary artery bypass surgery.

That’s from “Examining our Biases About Mental Illness,” the Editorial in the February issue of AJN by clinical managing editor Karen Roush, MS, RN, FNP-C. What biases and assumptions about the mentally ill, the depressed, the anxious have you seen in your practice? Do you ever find yourself slipping into such biases yourself as a kind of default setting?

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Posted in Karen Roush, nursing perspective | Tagged , , , , , | 4 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 nursing perspective, children's health | Tagged , , , , | Leave a Comment »

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When Lawmakers and Physicians Hold Nurses Back

February 13, 2012

Editor’s Note: Toni Inglis, MSN, RN, CNS, FAAN, writes opinion for the Austin (TX) American-Statesman. She works at the Seton Healthcare Family in Austin as a neonatal ICU staff nurse and also writes a nursing blog for Seton and edits its monthly NursingNews. This article is a reprint of an April 22nd commentary in the Statesman. Toni was inspired to write the column after a particularly disappointing legislative session, in which Texas advanced practice nurses made fewer gains than in past sessions—despite Texas ranking last in access to health care and having the most restrictive laws in the country regarding APRN scope of practice and prescriptive authority. She believes the poor access and barriers to practice are related.

AJN finds the article particularly relevant as legislatures across the country deliberate on APRN barriers to practice. You can read her commentaries at ingliscommentary.com.

Here’s an idea that wouldn’t cost Texas a dime but would save millions of dollars every year: Remove all barriers restraining nurses from practicing to the full extent of their education and training.

by Brian Romig/via Flickr

No state needs primary care providers more than Texas, which has a severe shortage. Texas ranks last in access to health care and in the percentage of residents without health insurance. Of Texas’ 254 counties, 188 are designated by the federal government as having acute shortages of primary care physicians. Of that number, 16 counties have one and 23 have zero.

If every nurse practitioner and family doctor were deployed, we still couldn’t meet the need. Texans are desperate for health care.

Doing the math and to help meet the need, the Legislative Budget Board recommended autonomous practice of advanced practice nurses after a preceptorship.

In Texas, our legislature — session after session — keeps the most restrictive laws in the country. Nurse practitioners don’t want to perform brain surgery. They just want to provide primary care and are quick to refer cases to a doctor when necessary.

Most states with far less need do not legislate practice barriers to nurse practitioners. Given the severity of our problem, shouldn’t we at least bring ourselves in line with those other states? Read the rest of this entry ?

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Remembering the Big Picture, Hypothermia, Nursing Books of the Year

January 20, 2012

From its earliest beginnings, nursing has embraced a holistic view of health. What we eat, the environments in which we work and live, our social relationships—all these influence health. Yet, as nurses, many of us shy away from looking at the big picture; instead we narrow our focus, addressing only the immediate problems of this patient, this family. It’s true that many patients treated in hospitals or outpatient clinics are there only for a short time. But how will such patients and their families fare in the long run if they lack access to public transportation to get to their follow-up appointments? How can patients recover from illness when they must choose between paying the mortgage and filling prescriptions?

That’s an excerpt from “Voices Rising,” the editorial in the January issue of AJN by Shawn Kennedy, editor-in-chief. We hope you’ll take a moment to read the whole thing and give it some thought.

Also in the January issue, you’ll find plenty of reading suggestions in the AJN 2011 Book of the Year Awards; a CE on the causes, diagnosis, and management of hypothermia; and a great deal more, including a feature, “Cardiac Catheterization Through the Radial Artery,” that advocates the use of the transradial artery rather than the femoral artery for cardiac catheterization in certain situations.—JM, senior editor

Posted in advocacy/political action, Shawn Kennedy, AJN editor-in-chief | Tagged , , , , , | 2 Comments »

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Poll: What Can We Actually Do About Hospital Room Noise?

January 17, 2012
By ArtsieApsie, via Flickr

Fierce Healthcare reports this week on the latest findings about hospital room noise: ”hospital rooms can be as noisy as chainsaws, according to a new study [subscription required] published this week in the Archives of Internal Medicine….The average noise level in patient rooms was close to 50 decibels….The noise disruptions mostly come from staff conversation, roommates, alarms, intercoms and pagers….Loud hospital rooms are associated with clinically significant sleep loss among patients and even may hinder recovery.”

So, nurses (and patients, MDs, others): can anything be done about this? Does your hospital do anything? Take our poll, and also of course feel free to leave a comment on this post.—JM, senior editor


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Diabetes Plus Marijuana Plus Medical Errors Minus Nursing Blogs

January 12, 2012

What’s new in health care news this week?

Diabetes everywhere. There’s an entire Health Affairs issue devoted to the topic of “Confronting the Growing Diabetes Crisis.” It looks at many interrelated issues, such as the personal financial burden of having diabetes over the course of a lifetime, whether it’s best to put scarce health care resources into focusing on prevention or treatment, models for community-based lifestyle programs for those with type 2 diabetes, the positive effects of the Affordable Care Act on giving those with diabetes access to affordable health insurance and crucial care, genetic factors related to type 2 diabetes, and a great deal more. Inevitably, many of the articles focus on type 2 diabetes, which is so closely linked to America’s obesity epidemic.

by Jorge Barrios, via Wikimedia

Joint studies. The New York Times reported this week on a large government study showing that, whatever one believes about marijuana’s psychological effects or the efficacy of its various medical uses, long-term marijuana smoking—at least one joint per day, every day of the year—does not impair lung function or contribute to the development of COPD. Will this change anyone’s mind about whether this drug is evil, a panacea for all ills, or somewhere in between? Probably not.

Unreported harm. The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services issued a report last week stating that only 14% of medical errors and other events that harm Medicare patients were reported by hospital employees. The report calls for improving reporting systems and the creation of a list of ”potentially reportable events.” According to the New York Times story on the topic, adverse events that have gone unreported include ”medication errors, severe bedsores, infections that patients acquire in hospitals, delirium resulting from overuse of painkillers and excessive bleeding linked to improper use of blood thinners.”

Which leads us (or does it?) into nursing blogs. Many of the ones in our blogroll have been pretty silent in the past few months, or longer, and it’s not clear why. Some bloggers are taking a break, some have burned out or decided to use their time for other things (like going back to school), some have simply decided to spend more time on Facebook or sharing their thoughts by ’microblogging’ on Twitter (or are simply playing lots of Words With Friends on their smartphones). There are almost certainly many interesting new nursing blogs we don’t yet know about that are taking their places. If you know about them, please let us know. We need to take some time and do some digging. And we plan on doing a serious revision of the blogroll in the next few weeks.—JM, senior editor  

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Posted in patient safety | Tagged , , , , , , , | 5 Comments »

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