Jacob Molyneux, senior editor/blog editor, Author at Off the Charts

The Present: What This Visiting Nurse Has to Give

Illustration by Barbara Hranilovich for AJN.

It can be daunting for a visiting nurse to enter a patient’s home, especially if the patient seems less than receptive to the nurse’s efforts. In this month’s Reflections essay, “The Present,” Pia Wolcowitz describes one of her first assignments as a visiting nurse. She’s sent to assess a woman newly diagnosed with lung cancer. Here’s an excerpt:

I rang the bell and heard a voice, but couldn’t make out what she said. I rang again. This time I heard her loud and clear. “If you wanna come in, come in! Door’s open!” Entering, I found a woman in her mid-60s sitting hunched at her kitchen table, surrounded by bottles of medication and a bowl of cereal. It was way past noon.

She had cropped blue-black hair with accents of white. She studied me a moment, then her gray eyes examined my ID. “So, you’re the nurse?”

[…]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:02:10-05:00August 10th, 2015|narratives, Nursing, nursing perspective, patient engagement, Patients|1 Comment

Heatstroke in Older Adults: A Short Step from Heat Exhaustion

Signs and Symptoms of Heat Illness

Older adults tend to be more vulnerable than younger adults in a number of ways, one of which is in their reaction to intense heat.

Given the increase in extreme weather events in recent years, an article that we published a few years back, “Heatstroke in Older Adults” (free until September 1), is as timely now as ever. A high percentage of heat-related deaths in the U.S. occur among people who are 65 or older. Here are some of the reasons:

Older adults’ normal temperature-regulating processes may be impaired by illnesses such as diabetes or cardiovascular disease or by medications such as vasoconstrictors or diuretics, leaving them more vulnerable to heat exhaustion, which can progress to heatstroke, a far more dangerous condition. Those who are immobilized or suffer from disorientation secondary to dementia may fail to recognize dangerous symptoms or to drink appropriate types and amounts of fluids or move to a cooler location. Isolation, which is also frequently associated with heat injury, is common among older adults, particularly in cities, which are more susceptible to extreme heat waves because they create ‘heat islands,’ where surface and air temperatures are as much as 10°F higher than those in surrounding areas.

This short article gives nurses essential information on:

the differences in symptoms and treatment between heat exhaustion and heatstroke
the two types of heatstroke (exertional and classic)
the various risk factors for heat exhaustion and […]
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Jacob Molyneux, senior editor/blog editor2016-11-21T13:02:16-05:00July 22nd, 2015|Nursing|0 Comments

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

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 virus […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:02:17-05:00July 16th, 2015|Nursing|1 Comment

The Challenge of Bearing Witness to Patient and Family Suffering

“How do I honor this pain so that it teaches and blesses and does not destroy?”

By Jacob Molyneux, AJN senior editor

This month’s Reflections essay (“Why?“) is by a pediatric chaplain. As the title indicates, it’s about the questions we all ask in the face of suffering and loss. The precipitating event for the author is the baffled, enraged cry of a father who has lost a child, and her own struggles with the impossibility of giving an acceptable answer—to the child’s parents, or to herself as a daily witness of loss and suffering.

How does a chaplain, or for that matter a nurse, witness the pain of patients and their families time and again and keep from either shutting down or being overwhelmed by the stress and emotion? As we’re often reminded, self-care matters or there’s nothing to give the next time: yoga, gardening, humor, family, cooking, whatever works for a person. Is it enough? Yes, and no, says the author. Here’s an excerpt: […]