About Amy M. Collins, managing editor

Managing editor, American Journal of Nursing

Dosing Cups, Oral Syringes, or Spoons: A Pediatric Medication Safety Recipe for Disaster?

pediatricdosingA recent article I came across in Pediatrics said that researchers found (during laboratory experiments) that four out of five parents made at least one dosing error when using either a dosing cup or an oral syringe to dispense liquid medication meant for children. As a new parent who has grappled with multiple dosing tools, I can’t say I am surprised.

Growing up, I remember syrupy medicines being doled out by my mother on spoons of varying size—a teaspoon or tablespoon—not a very accurate method when you also factor in that most spoons differ in shape and, probably, actual volume.

After my son had his first round of vaccines, the nurse told me that, in case he had a fever that night, the standard dose of Tylenol for his size and age was 80 mg. He didn’t get a fever in the end, and I didn’t think about what she’d told me until he had his first fever from a cold several months later.

When I went to open my box of Tylenol, I saw that the syringe that came with it did not use the dosage the nurse had told me (in milligrams), but rather, milliliters. I looked on the box for instructions but it only […]

2016-11-21T13:00:52-05:00November 1st, 2016|patient safety, pediatrics|0 Comments
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Former Navy Nurse Raises Awareness About the Lingering Effects of Agent Orange

Susan Schnall and a group of children at Tu Du Hospital, Ho Chi Minh City, in 2008. Susan Schnall and a group of children at Tu Du Hospital, Ho Chi Minh City, in 2008.

On August 10, 1961, the United States military first sprayed Agent Orange, a defoliant containing a particularly toxic dioxin compound, in Vietnam. Fifty-five years later, the effects of this and other chemicals linger on. And 48 years after former naval nurse Susan Schnall was court-martialed for protesting the Vietnam War, she visited Vietnam for the first time and witnessed these effects firsthand.

“In all my years in health care, I have never seen children with such severe birth defects,” Schnall said during an interview with AJN. After her court-martial, Schnall went on to have a successful 30-year career in hospital administration. After retiring and visiting Vietnam, she decided she needed to do something about what she witnessed there.

Schnall joined a group called the Vietnam Agent Orange Relief and Responsibility Campaign, made up of American Vietnam Veterans, Vietnamese Americans, social activists, and community leaders. The group aims to educate the public on the repercussions of the chemical warfare used in Southeast […]

2016-11-21T13:01:01-05:00August 15th, 2016|nursing perspective, nursing stories, Public health|0 Comments
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Just Breathe: A Nurse’s Tough Love Proves Crucial During One Mother’s Labor

Photo by chintermeyer, via Flickr. Photo by chintermeyer, via Flickr.

By Amy Collins, AJN managing editor

The pain jolted me from my sleep. It was 1:30 in the morning. The sensation was stronger than anything I’d ever felt, and I grabbed my phone to start my contraction timer. I had read loads on labor and childbirth, and everything suggested I was in for the long haul. But my timer was showing the contractions were already only five minutes apart. I spoke with the hospital’s on-call physician, who told me to relax and spend as much time as possible at home so I could be more comfortable.

But within minutes, the pain had increased to a level where it was difficult to talk. The contractions were now three minutes apart and my water had broken. My husband and I decided to go to the hospital.

I’d like to say I was strong and handled the pain of labor well, but I was quickly losing control and succumbing to anxiety. By the time we got to the maternity unit, I was sobbing. The labor nurse assigned to me introduced herself as Jean. She was older and seemed seasoned, with a stern, no-nonsense attitude. She brought me to a delivery room and gave me a gown. Before labor started, my plan had been to see […]

2016-11-21T13:01:25-05:00March 2nd, 2016|nursing perspective, patient engagement, patient experience|0 Comments
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Nurse Helps Prepare Police for Encounters with the Mentally Ill

Jeannine Loucks, MSN, RN-BC, PMH, with Captain Dan Cahill (left) and Chief Robert H. Gustafson at the Orange County Police Department in Orange California. Photo courtesy of the Orange Police Department. Jeannine Loucks, MSN, RN-BC, PMH, with Captain Dan Cahill (left) and Chief Robert H. Gustafson at the Orange County Police Department in Orange, California. Photo courtesy of the Orange Police Department.

By Shawn Kennedy, AJN editor-in-chief

Nurses—especially those in the ED—often interact with law enforcement in the course of their work. However, few go outside of their setting to get involved in the training of police officers. But that’s exactly what one mental health nurse, Jeannine Loucks, MSN, RN-BC, PMH, did when she noticed that state hospitals were releasing patients with mental illness into the community and felt officers needed more tools in their arsenal in order to handle their potential encounters with these people.

“Officers today have a difficult job managing crime fighting, community relations, and safety,” Loucks said. “They’re also expected to be mediators and therapists.” She wanted to help both the officers and the patients, and so developed a training program not only for the local police, but eventually for people who worked security throughout her city of Orange, California. What started off as a local community initiative eventually grew, and through the use of training videos the program is now being used by police departments throughout her state and is also available by request to departments across the country.

In […]

2016-11-21T13:01:26-05:00February 22nd, 2016|nursing perspective|0 Comments
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Health Technology Hazards, 2016: Inadequate Disinfection of Flexible Endoscopes Tops ECRI List

hazard/jasleen kaur, via Flickr hazard/jasleen kaur, via Flickr

The ECRI Institute has released its Top 10 Health Technology Hazards for 2016 report, highlighting health technology hazards for health care facilities and nurses to focus on this year.

Although alarm hazards, which topped the list for the past four years, still pose a significant threat, topping the list at number two, a different repeat offender has claimed the number one spot: inadequate cleaning of flexible endoscopes before disinfection.

Proper reprocessing and cleaning of biologic debris and other foreign material from instruments before sterilization is key, according to the report. And flexible endoscopes, especially duodenoscopes, are difficult to clean because of their long, narrow channels. Failure to clean properly can result in the spread of pathogens. The report points to a series of fatal carbapenem-resistant Enterobacteriaceae infections in the last two years to illustrate this particular threat, and recommends that facilities emphasize to their reprocessing staff that inattention to proper cleaning steps can lead to deadly infections.

Some hazards, such as those arising from health information technology (HIT) issues, insufficient training of clinicians in operating room technologies, and failure to appropriately operate intensive care ventilators, have been touched on in previous years. (See our past posts on ECRI top 10 health technology hazards from 2013, 2014, […]

2016-11-21T13:01:33-05:00January 14th, 2016|Nursing|3 Comments
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