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

Nursing, HIV/AIDS, Continuity of Care, Treatment Advances, and the ACA: The Essentials

As the Affordable Care Act takes effect, a timely overview in AJN of recent developments in screening, treatment, care, and demographics of the HIV epidemic

The ‘cascade of care’ (from the AJN article)

The newly released March issue of Health Affairs is devoted to looking at the ways the Affordable Care Act (ACA) will affect Americans with HIV/AIDS and those who have recently been in jail. One crucial feature of the ACA is that it prevents insurance companies from refusing coverage to those with a number of preexisting conditions. If you have a preexisting condition and don’t get insurance through work, you know how important this is.

Unfortunately, a large majority of those with HIV and AIDS do not have private health insurance. One article in the March issue of Health Affairs draws attention to the plight of the 60,000 or so uninsured or low-income people with HIV or AIDS who will not receive health insurance coverage because their states are among those that have chosen to opt out of the ACA provision that expands Medicaid eligibility. This means many patients in these states may lack consistent care and reliable access to life-saving drugs.

Antiretroviral therapy (ART) improves patient quality of life and severely reduces expensive and debilitating or fatal long-term health problems in those with HIV/AIDS. As noted in AJN‘s March CE article,

Jacob Molyneux, senior editor/blog editor2016-11-21T13:05:17-05:00March 6th, 2014|health care policy, nursing perspective|3 Comments

Acknowledging Nightingale’s Pervasive Influence on Medicine as We Know It

By Jacob Molyneux, senior editor

Florence Nightingale in Crimean War, from Wikipedia Commons

There’s a very good article about Florence Nightingale in the New York Times right now (“Florence Nightingale’s Wisdom”)—and it’s by a physician.

The author, Victoria Sweet, writes that Nightingale was the last person she wanted to know about or identify with when she was in medical school. Then she gradually began to realize Nightingale’s extraordinary influence on modern medicine as it’s now practiced. As Sweet point out,

So much of what she fought for we take for granted today — our beautiful hospitals, the honored nursing profession, data-driven research.

It’s a good piece, and though you may already know some of what it covers, it’s well worth reading. For those who want to learn more about Nightingale, let me point out a series of short posts we ran back in the summer of 2010 on this blog. In Florence’s Footsteps: Notes from a Journey, written by Susan Hassmiller, senior advisor for nursing at the Robert Wood Johnson Foundation, detailed the stages of a trip she took that summer as she retraced Nightingale’s steps through England and all the way to the Crimea, all the while contemplating her legacy.

Jacob Molyneux, senior editor/blog editor2016-11-21T13:05:17-05:00March 4th, 2014|career, nursing history, nursing perspective|3 Comments

NPR Syndrome

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

calligraphy, 36″ x 24,” mixed media on vellum, 2007, by julianna paradisi

Compassion fatigue is a syndrome commonly known to nurses and other professionals involved in patient care. It is the result of constant exposure to traumatic events occurring to others. Its effects on the psyche of nurses are widely studied, recognized as a factor in burnout and self-medication, and sometimes result in nurses leaving the profession.

My clinical practicum as a nursing student, nearly 30 years ago, was in oncology. There I saw patients succumb to cancer. Many were young adults. One left behind a grieving husband, and an infant. It was heartbreaking. I asked my preceptor, a skilled, compassionate, and uncannily jolly nurse, how did she avoid burnout? I did not know about compassion fatigue yet.

She wisely replied, “You need to develop a happy, fulfilling personal life outside of nursing. You have to shut it off when you leave the hospital.” It was good advice.

I took it to heart, and over the years developed a happy, fulfilling personal life. However, turning it off when leaving the hospital […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:05:21-05:00February 21st, 2014|career, nursing perspective|8 Comments

The Hospital as Foreign Country

“A Foreign Place,” the February Reflections essay by Barbara Sosman, delves into one patient’s experience of the sometimes inscrutable, sometimes terrifying, sometimes humorous events and encounters in one small corner of a hospital.

Below are the first two paragraphs, but as always, it’s worth clicking through and reading the entire essay (the PDF version is best). This one would be particularly hard to summarize; it takes us to unexpected places.—Jacob Molyneux, senior editor

The flow of life and death in a hospital is mysterious, like the sound of a foreign language, and the mysteries that bring us here are profound. Stretched out in an unfamiliar hospital bed, I suppress realities, aware that tomorrow a scalpel will remove an enlarged node for a biopsy. The biopsy will show what I sense, a cellular chaos that threatens my life. Soon my disease will be presented like an offering. What will I do with it?

A room can become a universe and time there an infinity. This room is inhabited by women, of whom I am the youngest by decades . . .

As always, comments are welcome.

Jacob Molyneux, senior editor/blog editor2016-11-21T13:05:27-05:00February 7th, 2014|nursing perspective, patient engagement, patient experience|0 Comments

AJN’s Top 15 Most Viewed Articles in 2013

by rosmary/via Flickr

We thought readers might be interested in seeing which articles and topics got the most page views in 2013. Many of these articles are open access, including a number of CE articles as well as the articles from our Evidence-Based Practice: Step by Step series. Some articles require an AJN subscription or individual article purchase. Several of the articles in this list were from recent years other than 2013; a couple were much older, but are evidently still relevant, since not every idea in nursing is ephemeral or subject to improvement by the next generation.—Jacob Molyneux, senior editor

1. “Asking the Clinical Question: A Key Step in Evidence-Based Practice” – (March, 2010) – part of AJN‘s EBP series

2. “Improving Communication Among Nurses, Patients, and Physicians” – (November, 2009)

3. “The Seven Steps of Evidence-Based Practice” – (January, 2010) – part of our EBP series

4. “Nurses and the Affordable Care Act” – (September, 2010)

5. “From Novice to Expert: Excellence and Power in Clinical Nursing Practice” – (December, 1984; not HTML version; readers must click through to PDF version)

6. “COPD Exacerbations” – (CE article; February, 2013)

7. “Therapeutic Hypothermia After Cardiac Arrest” – (CE; July, 2012)

8.