About Amy M. Collins, managing editor

Managing editor, American Journal of Nursing

The Elusive Strict Diet

By Amy M. Collins, associate editor

Several days ago, we linked on our Facebook page to an abstract of a JAMA article that found that women hospitalized for myocardial infarction were more likely than men to present without chest pain. A few days later, my 59-year-old mother was told by her general practitioner that her ECG had shown an electric “blip” that could be due to scarring from an unnoticed heart attack. My mother—always too lax about these things (unlike her hypochondriac daughter)—calmly told me she always has random chest pains and it could have happened at any time.

A visit to the cardiologist a few days later eased our fears. She hadn’t had a heart attack, but was diagnosed with right bundle branch block and has to undergo further testing. With high C-reactive protein levels, elevated cholesterol, and a history of heart disease in the family, one can’t be too careful. A stress test and cardiac ultrasound have been ordered.

In discussing her cholesterol level, which had increased since my mother’s last wellness exam, the cardiologist suggested she start taking statins. Not keen on medication, and worried by recent reports of adverse effects from these drugs, she said she’d rather only start with that if there were no other options. His suggestion […]

2016-11-21T13:10:30-05:00March 14th, 2012|patient engagement, personal health practices, Public health|4 Comments
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The Cruel Irony of Alzheimer’s Disease

By Amy M. Collins, associate editor

As I watch my grandmother navigate the murky waters of her Alzheimer’s disease, it continues to surprise me that parts of her brain work at warp speed, while other parts seem to be completely defunct. For example, although she can’t remember what she’s done from one minute to the next, she can make up a lie to compensate for the memory loss in less than 30 seconds.

“Where did you get that new necklace, Grandma?” I recently asked at a family party. “Oh I bought it at the place where I work, you know, I type at a school,” she said, with certainty. Or when asked where she got a new sweater, she told my mother she went to the store. “How did you get there?” my mother asked. “I drove,” she said. “But you don’t have a car.” “Oh, well then I must have walked.”

She no longer remembers my name unless prodded, but she does remember that she has a cat in her room at the independent living center, and worries about it constantly. “I have to get back to take care of my cat,” she says when she visits us, becoming increasingly stressed the longer she’s away. Yet it’s hard for her […]

2016-11-21T13:10:47-05:00February 6th, 2012|patient engagement, Patients|7 Comments
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Health Technology Hazards: Top 10 for 2012

Advances in health technology can save patients’ lives, but can also cause harm, as the recent Ecri Institute report, Top 10 Technology Hazards for 2012, reminds us. Here’s a snapshot of the hazards nurses should be focusing on, and some suggestions they give on how to prevent them.

1. Alarm hazards
The risk: With nurses being constantly bombarded by bells, it’s easy to see how alarm fatigue can set in, leading to desensitization, nurses being unable to distinguish the urgency level of alarms, and improper alarm adjusting.

Some suggestions: According to the report, a facility should look at the big picture, examining the entire alarm environment when setting up an alarm-management system. Alarm notification and response protocols should be developed to ensure that each alarm will be recognized, that the appropriate caregiver will be notified, and that the alarm will be promptly addressed. Policies should also be established to control alarm silencing, modification, and disabling.

2. Radiation exposure
The risk: High levels of radiation used during radiation therapy can cause serious harm if errors occur, including damage to normal tissue and organs. And despite radiation levels being lower in diagnostic settings, the increasing number of patients undergoing diagnostic radiography may reveal more risks in the future.

Some suggestions: The report suggests that […]

2016-11-21T13:11:03-05:00January 5th, 2012|Nursing|0 Comments
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Health Care Work and Hypochondria: When Knowledge Equals Fear

By Amy M. Collins, associate editor

This Thursday I will graduate. Not from college—sadly, that was many years ago. Rather, I will finish a health anxiety class, taken in desperation when untimely hypochondria struck. I admit it. I’ve always been a bit of a worrier when it comes to health and illness. Working as a health care writer/editor doesn’t always help. I just have too much information at my fingertips, and a brain that jumps to the extreme (a pain in the side can mean cancer, and so on).

Before getting a degree in writing and journalism, I studied human biology with the intention of going into some type of health care work. But reading about diseases made me start to self-diagnose with fervor, so I decided to switch majors. And this was before the advent of the Internet, where one can constantly consult “Dr. Google.”

Years ago, while working at a medical publishing company in Spain, things got worse. I was put on the cardiovascular beat, which only increased my health fears. Diagnosed with mitral valve prolapse as a child, and on medication for arrhythmia at the time, reading about this particular disease made my heart literally flutter. My boss, recognizing my discomfort, took me off the topic and asked me to instead […]

2016-11-21T13:11:10-05:00December 14th, 2011|Nursing|4 Comments
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Say It Ain’t So: Another ‘No’ on the Cookie Dough

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

I admit it. For me, the best part of baking chocolate chip cookies is eating the raw dough. I know there’s a risk for a food-borne illness, but it’s hard to resist at least one mouthful—well, maybe two—of that combination of brown sugar, butter, and chocolate chips. Now, just in time for the holiday baking season, there’s even more evidence that taking that bite is not such a great idea.

A recent study by Neil and colleagues found that a 2009 outbreak of Escherichia coli was associated with eating raw cookie dough: 77 people across multiple states came down with an E. coli O157:H7 infection. The researchers found the common exposure was to a  ready-to-bake, prepackaged cookie dough that the patients had eaten raw. They believe the most likely culprit in the dough was contaminated flour. (The researchers note that flour has been implicated in food-borne Salmonella and E. coli outbreaks in the past.)

So, when educating patients about safety this holiday season, remind them that food products meant to be cooked or baked should never be eaten raw. As for me, this holiday I think I’ll head to the bakery and stay out of temptation’s way.

What other holiday safety tips have you got for patients?

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2016-11-21T13:11:11-05:00December 12th, 2011|Nursing|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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