Tuberculosis: Nurses Play Critical Role in Prevention, Diagnosis, Treatment

Mantoux skin test/CDC PHIL

In the U.S., the chances are that tuberculosis isn’t on your mind a lot. Most of us focus on TB only when we have a patient on airborne precautions—or when we’ve been exposed to TB at work.

Globally, TB was one of the top 10 causes of death in 2015. In the U.S., after a spike in cases early in the HIV epidemic, the incidence of TB has fallen to about three cases per 100,000 people. In TB-endemic countries, incidence rates run into hundreds per 100,000. But with TB elimination defined as a rate of less than one case per million people, we are far from eradicating this disease in the U.S. In fact, the number of TB cases in the U.S. rose slightly from 2014 to 2015.

Also, of course, nurses often work with people who are at high risk of acquiring TB—transplant recipients, others who are immunocompromised, people with HIV or certain cancers, those who are refugees or homeless—increasing our own risk for the disease as well. Therefore, the low overall U.S. incidence rate doesn’t reflect the experience (or risk) of most nurses. (And if you are “PPD positive,” click here for some reminders about what that should mean to you as a nurse: “Nurses and Latent TB Infection.”) […]

Designing Nurses: Make Your Ideas Reality

“At one hospital I worked, nurses used masking tape to outline a box on the floor around the resuscitation stretcher…”

Earlier this month, the New York Times published an article, “Design Thinking for Doctors and Nurses.” In it, the author describes a simple solution designed by a nurse to identify who was in charge of a resuscitation team: whoever was wearing the orange vest was the leader.

As a former ED nurse who participated in many codes and trauma emergencies, I could easily picture the chaotic scene that led to this innovative solution. In a large urban teaching hospital, cardiac arrests and trauma calls draw many physicians and medical students, respiratory therapists, and of course, at least two to three nurses. It wasn’t unusual to have conflicting orders shouted out by physicians, residents chiming in with questions and suggestions, and the medication nurse making the decision as to which order she/he would process. At one hospital I worked, nurses used masking tape to outline a box on the floor around the resuscitation stretcher—only the physician in charge and resuscitation team were allowed inside the box. All other onlookers (mostly medical students and residents) had to stay outside the box and be silent. It did wonders for instilling a quiet, organized atmosphere into a highly charged event.

Left out […]

2017-08-16T09:22:11+00:00 August 16th, 2017|Nursing, nursing perspective|0 Comments

U.S. Life Expectancy Varies Depending on County of Birth

image via Wikimedia Commons / Wapcaplet

A new study that compared life expectancy by county from 1980 to 2014 has shed light on geographic disparities, which have been increasing over the past 35 years. One of the study’s major findings, as we report in an August news article, is that the difference in life expectancy between the U.S. county with the highest life expectancy and the one with the lowest is 20.1 years.

The counties with the lowest life expectancies include several in North Dakota and South Dakota (in particular, those with Native American communities), and counties along the lower half of the Mississippi River and in Kentucky and West Virginia. Meanwhile, counties in central Colorado have the highest life expectancies.

While national life expectancy increased from 73.8 years to 79.1 years during the study period, the researchers noted regional inequalities in this improvement: some counties in the South experienced little to no improvement in life expectancy, while others on both coasts and in Colorado and Alaska saw large increases. They also found that geographic differences in life expectancy decreased for children and adolescents but increased for adults—especially for those ages 65 to 85 years. […]

2017-08-11T09:04:39+00:00 August 11th, 2017|Nursing|0 Comments

When Brokenness Transforms Nursing

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California and blogs at http://heartofnursing.blog. Her Reflections essay, “Intimate Strangers,” appeared in AJN‘s August issue.

photo by Karen Roush/all rights reserved

I’ve had opportunities to sit in peer interview panels for new grad nurses looking to start their career in our unit, an experience which prompted me to consider what it takes to be a good nurse.

The obvious qualities were, well, obvious: critical thinking skills, strong communication, compassion, teachable, team player. But I’ve had a sense for a while that we nurses have been missing something when we consider what it takes to be a good nurse. While this something is strongly tied to empathy, it’s still a bit different. I tend to think of it as the nurse’s recognition and embrace of his/her own brokenness, even as the nurse looks to take care of others who are in some manner broken.

By brokenness, if the term is unfamiliar, I simply mean the awareness that we all know what it is to suffer, to struggle, to feel lost or wounded or weak. So in speaking of brokenness, I don’t mean it as a condescending lens through which we view everyone as objects to be fixed. I […]

2017-08-10T16:30:09+00:00 August 9th, 2017|Nursing, nursing perspective|3 Comments

Intimate Strangers: A Pediatric Intensive Care Nurse Reflects

By Lisa Dietrich for AJN.

“How do I talk about these things with a stranger unless I know how to be intimate?” asks pediatric intensive care nurse Hui-wen (Alina) Sato, the author of “Intimate Strangers,” the Reflections essay in AJN’s August issue.

Sato writes about “walking intimately . . . through the most devastating hours of her life” with a woman she’s only just met—even as her role as a nurse involves ending the life-sustaining treatments of this mother’s child.

Nurses will tell you such experiences can be common in their profession. But essays like this remind us that such experiences are also remarkable. Sato is the type of nurse who ponders her role, who stops after the fact to wonder what it means to be a participant at such moments in others’ lives. […]

2017-08-04T10:51:54+00:00 August 4th, 2017|Nursing, nursing stories, patient engagement|0 Comments