Amy M. Collins, managing editor, Author at Off the Charts

Talking About Death: Not Nice, But Necessary

Photo by Eliza Peyton, via Flickr

By Amy M. Collins, editor

Our recent blog post on “death panels” triggered a memory of my own first real experience with the death of a loved one. It was a little over 10 years ago. I was living overseas when my mother called to tell me my grandfather had liver cancer and had been given maybe a year to live.

The physician had given my family three choices: the aggressive choice, chemo; a less aggressive treatment with an experimental drug that had moderate success; or to let him live out the rest of his numbered days. We chose the middle ground.

At the time I worked in medical publishing and thought I knew everything. Over the weeks that followed I would call home to get progress reports, usually putting my two cents in about what my family should be asking the physician. Finally, when things seemed to be getting worse, I flew home to help.

Nothing could have prepared me for the emaciated man I found sitting up in bed when I went to my grandparents’ house to visit. I hardly recognized my grandfather. It hadn’t been that long, but the cancer had already ravaged him. Despite this, he was cheerful and had high hopes. He didn’t […]

Amy M. Collins, managing editor2016-11-21T13:09:37-05:00July 25th, 2012|patient engagement, Public health|4 Comments

Making a Case for Therapeutic Hypothermia

Photo © Rick Davis 2011.

One of the articles published in AJN’s July issue that’s proving popular is “Therapeutic Hypothermia After Cardiac Arrest,” by Jessica L. Erb, an acute care NP at the University of Pittsburgh Medical Center Presbyterian Shadyside Hospital, and colleagues Marilyn Hravnak and Jon C. Rittenberger. The article points out that, despite evidence supporting its effectiveness, therapeutic hypothermia is not widely used.

According to the article’s overview, “Irreversible brain damage and death are common outcomes after cardiac arrest, even when resuscitation is initially successful. Chances for both survival and a good neurologic outcome are improved when mild hypothermia is induced shortly after reperfusion. Unfortunately, this treatment is often omitted from advanced cardiac life support protocols.”

The article discusses the efficacy of therapeutic hypothermia, indications and contraindications for its use, various induction methods, associated complications and adverse effects, and nursing care specific to patients undergoing this procedure.

Read the article (it’s open access)—you can earn 2.3 hours of CE credit.—Shawn Kennedy, AJN editor-in-chief

Amy M. Collins, managing editor2016-11-21T13:09:39-05:00July 23rd, 2012|Nursing|2 Comments

Gym Class, or Physical Education?

Photo by Krossbow, via Flickr

By Michael Fergenson, AJN senior editorial coordinator

Gym class. Some of us may have memories of a brusque man tossing a ball into the middle of the gym, telling us to play and occasionally blowing a whistle. Popular culture certainly portrays the “gym teacher” in this way—or worse, sometimes they’re cast as the villain. I put gym teacher in quotes in the last sentence because my dad would get angry with me if he heard that term, or “gym class” for that matter. My father considers himself a physical educator. When people call him a gym teacher, which is most of the time, he replies with the quip: “The gymnasium is the room that I teach in, but I am a physical education teacher.”

There’s something more important going on here than mere semantics. Is this pop cultural view of the gym teacher causing harm to students? I believe so.

My father has been a physical educator for a little more than 20 years. For a long time I had the same negative view of gym teachers as most people. That was until I began to study education myself. I definitely wasn’t going to be a gym teacher—oh no, it was literature for me. I would be a high school English teacher, […]

Amy M. Collins, managing editor2016-11-21T13:10:03-05:00May 23rd, 2012|Nursing, personal health practices|3 Comments

How Good Are Your CPR Skills? Research Shows Monthly Practice Is Crucial

A nurse practices CPR on a voice advisory manikin. Photo courtesy of Laerdal Medical.

By Maureen Shawn Kennedy, AJN editor-in-chief

Most of you are probably aware of the AHA’s revised CPR guidelines that were issued in 2010. They include a major change in the resuscitation sequence—which now begins with chest compressions rather than ventilation—and emphasize the importance of achieving adequate compression of the chest—“at least two inches (5 cm)”—to achieve adequate blood flow. (You can see a video by the AHA demonstrating the new guidelines here.) This change is especially important in light of recent research on CPR skills.

In 2011, Marilyn H. Oermann and colleagues conducted research with nursing students to determine how often one needs to practice CPR skills to maintain competence.

As she explains in an article in the May issue of AJN, students who practiced briefly each month not only maintained their skills, but improved them significantly by the end of 12 months.

In comparison, the skills of those who only had an initial training session deteriorated after three months; by 12 months, few could perform CPR adequately, especially in terms of achieving adequate depth for chest compressions. And although these were students, Oermann describes studies showing similar results with paramedics, non-ICU nurses, and nurse anesthetists.

Most hospitals and agencies only require an annual review or demonstration of skills to be recertified in CPR; few, I bet, measure the depth of compressions. Sounds like it’s time to revisit this […]

Amy M. Collins, managing editor2016-11-21T13:10:10-05:00May 11th, 2012|Nursing|1 Comment

E-Cigarettes: Positive Smoking Substitute or a New Problem Replacing the Old?

Photo by Michael Dorausch, via Flickr

By Michael Fergenson, senior editorial coordinator

The dangers of smoking cigarettes are well documented, from the terrifying commercials about what smoking does to our bodies to the warnings right on the pack. Yet the Centers for Disease Control and Prevention estimates that 45.3 million people in the United States smoke.

Now, a new trend in tobacco products has become the center of much debate. I’m referring to the electronic cigarettes, or e-cigarettes, that are gaining popularity as a smoking alternative and, for many, as a tool to quit.

I personally know two people who are using this device in an attempt to stop smoking. An article published in the New York Times last November reports that the number of Americans trying e-cigarettes “quadrupled from 2009 to 2010.” The article also cites the results of a survey published in Tobacco Control last year, which found that 1.2% of adults, or close to 3 million people, had reported using these products in the previous month. But are e-cigarettes really a positive smoking substitute and aid to quitting?

How they work. Most e-cigarettes are shaped like a real cigarette, but some have a unique look. They work by heating up a liquid—purchased […]

Amy M. Collins, managing editor2017-03-10T16:53:37-05:00May 4th, 2012|Nursing|21 Comments

About Amy M. Collins, managing editor

Talking About Death: Not Nice, But Necessary

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Making a Case for Therapeutic Hypothermia

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Gym Class, or Physical Education?

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How Good Are Your CPR Skills? Research Shows Monthly Practice Is Crucial

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E-Cigarettes: Positive Smoking Substitute or a New Problem Replacing the Old?

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