About Jacob Molyneux, senior editor/blog editor

Senior editor, American Journal of Nursing; editor of AJN Off the Charts.

Recalling the Why of Health Care Reform

By Jacob Molyneux, AJN senior editor ACA ruling imageIn a brief analysis of the gradual rollout and effects so far of the Affordable Care Act (ACA) at the start of this year (“The ACA Continues to Run the Gauntlet”), I reviewed a few of the issues the law was intended to address when it was passed in 2010:

* the highest per capita expenditures of any health care system in the world

* consistently worse outcomes on measures such as infant mortality rate than most other developed nations

* increasing numbers of uninsured Americans each year, to over 50 million in 2009, the year before passage of the ACA

* unsustainable annual increases in health insurance premiums and drugs costs, leading to astonishing rates of medical bankruptcy

* a Medicare reimbursement process that rewarded the volume of care provided rather than the effectiveness of that care

These worsening issues had become impossible to ignore. No one believes the ACA is a perfect law; there were too many cooks in the kitchen for that. But it’s at least a good faith attempt to address real problems, to get a framework on the table that can potentially be improved upon. […]

2016-11-21T13:02:55-05:00March 4th, 2015|health care policy, Nursing, Patients|0 Comments
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The Delicate Dance for Stability

By Patricia O’Brien

Loïe Fuller sketched by Henri de Toulouse-Lautrec/via Wikimedia Commons Loïe Fuller sketched by Henri de Toulouse-Lautrec/via Wikimedia Commons

In college I got a part-time job as a companion to an elderly widow named Fran, driving her around town and assisting with errands: post office, hairdresser, the market, her psychiatrist. The routine was set, and all was well for many months.

But one day, something unusual happened. Fran opened her door with a grand flourish, eyes shining. The television, radio, and blender were blasting. “Shall we go,” I asked, hurrying to turn off the noisy electronics.

“Fran,” I observed, “the blender’s empty.”

“Let’s not bother with tiresome details. I’m out of my head today,” she said, with purposeful excitement. At the pharmacy, this time, I took notice of the medication I picked up for her: lithium.

“What’s lithium for?” I asked, sliding into the car.

“A bipolar disorder. Not to worry. I’ve navigated these choppy seas half my life.”

We did errands. All the while, she acted like she was on the campaign trail for mayor, laughing, waving to friends, and smoking up a storm. At the market she hugged the meat manager, who was arranging Italian sausages. He looked confused, but smiled and told her there was a special on calf’s liver.

“I’ll take it all,” she declared, […]

2016-11-21T13:02:57-05:00February 23rd, 2015|Nursing, patient experience, Patients|1 Comment
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Strong Nurse and Patient Voices On the Blogs This Week

By Jacob Molyneux, senior editor/blog editor

Photo by mezone, via Flickr. Photo by mezone, via Flickr.

Here’s a short Friday list of recent smart, honest, informative blog posts by nurses, as well as a couple of interesting patient perspectives on prominent types of chronic illness and the ways they are talked about by the rest of us.

At Head Nurse, in “Yes…No. I’m Having Some Thoughts About BSNs,” an ADN-prepared nurse makes some familiar and some more surprising observations about the effects of the new policy of hiring mostly BSN-prepared nurses at her facility as it tries for Magnet status. For example, one of the effects she notes is “a massive drop-off in terms of the diversity of our nursing staff.” The move toward BSNs is obviously the trend in nursing, and is supported by research, but this doesn’t mean that there aren’t still two sides to the issue, or real unintended consequences to address as this change is gradually implemented.

At Hospice Diary, the blog of hospice nurse Amy Getter, there’s a post called “Hearts, Flowers, and Bucket Lists.” Reflecting on the imminent death of a patient, the author puts the popular notion of bucket lists into perspective:

“I think about some of the things I would still […]

2016-11-21T13:02:58-05:00February 20th, 2015|career, healthcare social media, nursing perspective|0 Comments
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Fish Safety Concerns: Navigating the Waters

Considering the conflicting advice on eating fish that has appeared in the media over the past few years, the public is undoubtedly confused. Nurses and other health care professionals will likely find themselves having to address this issue, especially with pregnant and nursing patients and parents of young children, all of whom are likely to be concerned.

–(from “To Eat Fish or Not to Eat Fish” in the February issue of AJN)

Photo by Emilio Ereza/ag e fotostock Photo by Emilio Ereza/ag e fotostock

I’ve been hearing about the unexplained illness of a good friend’s close colleague for a number of months. Dozens of costly and invasive tests have been performed to explain her malaise, headache, chronic stomach and digestion problems, fatigue, dizziness, and so on. Recently, a potential culprit was identified: mercury poisoning. I don’t know all the facts, but her mercury poisoning may well have something to do with the fact that she eats sushi at least once a week, and perhaps a lot of other mercury-containing fish as well.

What does this have to do with nursing? Maybe a lot, in terms of providing sound nutritional advice to patients who might be at particular risk for mercury poisoning, or in terms […]

2017-07-11T14:49:23-04:00February 19th, 2015|Nursing, nursing perspective, Patients|0 Comments
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Paired Glucose Testing With Telehealth Support to Empower Type 2 Diabetes Patients

Jacob Molyneux, senior editor

bloodglucosetestingType 2 diabetes is challenging for those trying to meet blood glucose target ranges, often requiring one or more daily medications, increases in exercise, changes in eating habits, and self-monitoring of glucose level. Those who are willing and able to learn about factors affecting their glucose level and to make small daily efforts in one or more areas have the potential to radically improve their sense of control over their diabetes.

This month’s Diabetes Under Control column, “Better Type 2 Diabetes Self-Management Using Paired Testing and Remote Monitoring” (free until April 1), presents a successful story of patient engagement in diabetes self-management. It describes the case of a participant in a clinical trial who, with clinician support, incorporated paired glucose testing (self-testing before and after meals) and telehealth (remote patient monitoring, or RPM).

The article is easy to follow and gives a series of biweekly updates on the patient’s progress. Before the study starts, she’s not very engaged in self-management. For example, she’s only testing her own glucose level three to four times a month. To get a sense of how much more empowered she’s come to feel by week 12 of the protocol, consider this brief excerpt: […]

2016-11-21T13:03:02-05:00February 13th, 2015|digital health, Nursing, patient engagement, Patients|4 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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