About Jacob Molyneux, senior editor/blog editor

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

What Can’t Be Taught in Nursing School

JanuaryReflectionsBy Jacob Molyneux, senior editor

The January Reflections essay in AJN, “A Special Kind of Knowledge,” is a revised excerpt from a forthcoming book, Crossing the River Sorrow, One Nurse’s Story, by Janet L. Richards. (The book will be published in June by Vantage Press.) In the essay, the author remembers an encounter she had several decades ago as a nursing student caring for a newly paralyzed young woman. Here’s a paragraph from near the start:

I stood by Carrie during those first harrowing hours in the ICU as she awaited surgery, everyone still hoping for the best. As a brand-new student, I was a silent observer, unsure of how to participate. Her young husband also watched, slumped against the heater under the window at his wife’s bedside. His eyes blazed, wild with fear and disbelief as he struggled to make sense of his sudden immersion into the alien world of disability. I could identify. Pressure sores, urinary catheters, bowel programs, and spasms—these were now part of my new and ever-expanding medical vocabulary. A spinal cord severed at C6 meant life as a quadriplegic. Suddenly this book knowledge seemed all too real.

And here’s a few lines from near the end, to give a sense of the crucial insight the author gained as she struggled to bridge the gap between herself, her patient, and the patient’s husband:

Pain can be palpable as it moves across the space between two people, molten, […]

2016-11-21T13:08:32-05:00January 17th, 2013|nursing perspective, students|3 Comments
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How Bad Is the Flu Right Now, and Should Nurses Get Vaccinated?

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

The news has been full of reports about the influenza outbreak, deaths from complications, and shortages of vaccine and antivirals. Is the flu season as bad as purported, or are we experiencing media hype? Nurses are frequently asked for information by family, friends, and neighbors (and strangers—I was in a restaurant once and a diner at a nearby table, having overheard my conversation with a colleague, leaned over and asked if he could ask me a health question!), so here’s the latest information.

WeekEndingJanuary5FluView Week ending 1/5/2013; brown indicates states w/ widespread flu activity. CDC

According to the latest Centers for Disease Control and Prevention (CDC) report for the week ending January 5, epidemiologists from all states except three reported (see map) widespread “influenza-like illness” (ILI, meaning fever and cough or sore throat). California and Mississippi reported regional activity and Hawaii reported sporadic activity. The District of Columbia reported local spread. And while officials in some cities and states declared public health emergencies, the CDC notes that “influenza activity remained elevated in the U.S., but may be decreasing in some areas.”

One of the indicators is the proportion of people seeking treatment for ILI. Thus far, that number has risen as high as 6.0%, but has since fallen to 4.3%, as of January 5. In prior years deemed as moderately severe flu seasons, that indicator rose as high as 7.6%.

So in terms of history, we’re […]

2016-11-21T13:08:33-05:00January 14th, 2013|nursing perspective|6 Comments
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Web Pickings: 2013 Predictions, Good Fat, Mammograms, Moderation, Nurse Wisdom, More

By Jacob Molyneux, senior editor

Cartoon showing baby representing New Year 1905 chasing old man 1904 into history/ Wikipedia Cartoon showing baby representing New Year 1905 chasing old man 1904 into history/ Wikipedia

Ah, another new year starts (not 1905, despite the illustration) and received wisdom is overturned. Sort of. Consider the widely reported news that a JAMA study has found that being overweight doesn’t seem to increase your risk of dying, or, as the Kaiser Health News headline puts it, “A Little Extra Fat Could Be Protective.”

Many news summaries do point out that severely obese people had a higher risk of dying than did people of normal weight. What the study does and does not mean is being debated, with some pointing out that the study didn’t look at whether being overweight increased consumption of health care resources, number of prescribed medications, etc. We’re sure to hear more on this.

To continue with the theme of questioning long-term assumptions, NPR’s story “Breast Cancer: What We Learned in 2012” gives a nice summary of updated guidelines for who should and shouldn’t get mammograms, including pro and con arguments, the latest research, and so on.

Some pretty cynical journalism can be found in an opinion piece in the Palm Beach (Fl.) Post, which suggests that Hillary Clinton’s blood clot is a hoax.

A New York Times piece, in giving a tidy summary of important exercise-related research from the […]

2016-11-21T13:08:38-05:00January 2nd, 2013|nursing perspective|0 Comments
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A Mental Health Nurse’s Perspective on Newtown and Its Aftermath

Mary Magdalene Crying statue/Wikimedia Commons Mary Magdalene Crying statue/Wikimedia Commons

By Donna Sabella, MEd, MSN, PhD, RN, mental health nurse, AJN contributing editor, and coordinator of the monthly Mental Health Matters column

As we all know by now, last Friday, December 14, our nation was forced to bear witness to another act of unconscionable violence, as 20 children and six adults were gunned down inside their elementary school on a morning that began with the murder of the  gunman’s mother.

As the country ponders why and how this could have happened, we know that there are no easy answers. Those answers that we do arrive at will undoubtedly involve much thought and soul-searching. How could one human being, one lone gunman barely an adult himself, wreak such devastation on so many?

The pain and grief of Friday hangs heavy over Newtown, and only those who lost a child or loved one that day can begin to imagine the sorrow they are experiencing. But the sorrow and grief do not stop there. As President Obama stated on Sunday night in his remarks to the Newtown community, the nation collectively shares their sorrow, disbelief, and pain.

As we know, one need not be directly involved in an event to be affected by it. This horrible event forces us all to confront the notion that while we are the land of the brave and the home of the free, we share our land with evil, with senseless […]

2016-11-21T13:08:40-05:00December 19th, 2012|nursing perspective|1 Comment
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Precarious Hope: A Hospice Nurse Balances Truth and Kindness

This couple might be your elderly neighbors: he helps his wife into the house as she moves slowly, step by unsteady step, in time with her four-point cane; at the same time, you know that he is recovering from recent chemotherapy treatments. Or they may be your aging parents: your mother’s role as primary caregiver hampered by her right leg weakness from a stroke and advancing heart disease, while your father needs more care from day to day as his renal failure approaches the decision to begin dialysis or not. They support and care for each other.

PrecariousHopeIllustrationThe December Reflections column in AJN, “Precarious Hope,” is by an RN case manager at a hospice. She describes a couple in which one partner has dementia and the other has cancer, their mutual dependency, and the challenge of knowing how best to care for them:

In hospice, I’m often confronted with the difficulty of balancing honesty with kindness. I love a quote often attributed to the Buddha: “When words are both true and kind, they can change our world.” It follows that sometimes what is true is not kind, and that truth must be cloaked in kindness—as in this instance, as I sit at the table listening to George, whose hopeful, unrealistic comments confirm that he simply can’t hear the truth.

It’s a sensitive portrait of love, the fine line between self-delusion and perseverance, and the way that sometimes simply bearing witness is the […]

2016-11-21T13:08:44-05:00December 14th, 2012|nursing perspective|1 Comment
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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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