About Betsy Todd, MPH, RN, CIC

Clinical editor, American Journal of Nursing (AJN), and epidemiologist

The Words We Use to Talk About the Act of Suicide

    marie + alistair knock/flickr creative commons

Suicide. A dear friend of mine died this way almost 40 years ago, leaving behind a beautiful six-month-old boy and a beloved and loving husband. I have never given any thought to the way we friends and family refer to her death. Then last week, I came across a 2015 blog post by the sister of a man who died in the same way.

In the post on a website that shares experiences of disability and mental illness, former hospice social worker Kyle Freeman argues that this term suggests criminality. She points to laws in the U.S. that, until a little more than 50 years ago, defined suicide as a criminal act. Kyle feels this history has perpetuated a sense of shame and embarrassment in survivors.

“…the residue of shame associated with the committal of a genuine crime remains attached to suicide. My brother did not commit a crime. He resorted to suicide, which he perceived, in his unwell mind, to be the only possible solution to his tremendous suffering.”

Kyle believes that the common use of the phrase “committed suicide” is not only inaccurate but can add to the suffering of those who have lost friends or family in this way. She prefers the term dying by suicide. […]

Becoming a Family Caregiver

Photo by Judith E. Bell, via Flickr.

For me, the saga began six years ago, when I offered to help a family member with some spring cleaning. I knew his place was a mess, but attributed this, stereotypically, to a single man’s lack of interest in housekeeping.

When I dove into the work, I was first puzzled and then fearful at what I found: hundreds of pieces of unopened mail, years old, randomly stacked around the apartment; threatening letters from the Internal Revenue Service; correspondence from the city about a tax lien on his condominium. This, in the home of a man who, as an actor and writer, memorized scripts in two languages, had served on the national board of his union, and could solve complicated math problems without using a calculator. Clearly, something was wrong well beyond the state of his apartment.

In AJN’s September original research article, “The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia,” Kathleen Czekanski notes that “caregivers often assume the role of caregiving before they quite realize they are doing so.” In this qualitative study, Czekanski set out to gain an understanding of the caregiver’s experience in taking […]

2017-09-01T08:54:00+00:00 September 1st, 2017|nursing research|0 Comments

Tuberculosis: Nurses Play Critical Role in Prevention, Diagnosis, Treatment

Mantoux skin test/CDC PHIL

In the U.S., the chances are that tuberculosis isn’t on your mind a lot. Most of us focus on TB only when we have a patient on airborne precautions—or when we’ve been exposed to TB at work.

Globally, TB was one of the top 10 causes of death in 2015. In the U.S., after a spike in cases early in the HIV epidemic, the incidence of TB has fallen to about three cases per 100,000 people. In TB-endemic countries, incidence rates run into hundreds per 100,000. But with TB elimination defined as a rate of less than one case per million people, we are far from eradicating this disease in the U.S. In fact, the number of TB cases in the U.S. rose slightly from 2014 to 2015.

Also, of course, nurses often work with people who are at high risk of acquiring TB—transplant recipients, others who are immunocompromised, people with HIV or certain cancers, those who are refugees or homeless—increasing our own risk for the disease as well. Therefore, the low overall U.S. incidence rate doesn’t reflect the experience (or risk) of most nurses. (And if you are “PPD positive,” click here for some reminders about what that should mean to you as a nurse: “Nurses and Latent TB Infection.”) […]

The Human Microbiome: A Primer for Nurses

Image courtesy of Bard Medical Division.

​The human microbiome is a collection of organisms living on the skin and in our GI and reproductive tracts. Nurses know these “germs” are there, and traditionally we have regarded them as potentially dangerous. We try to eliminate as many as possible when we disinfect skin before injections, surgery, or other procedures. Yet, as noted by the authors of a continuing education (CE) feature in the July issue of AJN, “Health and the Human Microbiome: A Primer for Nurses,” new research increasingly demonstrates that these microbes affect our health in significant and often positive ways.

​” . . . once unequivocally regarded as dangerous invaders, [microbes] often serve us as integral companions, providing critical functions in fundamental human processes.”

​In this article, Katie Gresia McElroy and colleagues share many thought-provoking research findings about the human microbiome that are relevant to nursing. Some examples: […]

2017-07-24T10:33:11+00:00 July 24th, 2017|Nursing|0 Comments

Connecting Emotional Intelligence, Team Communication, and Patient Safety

An Early-Career Nursing Memory

Photo by Barry Diomede/Albany Stock Photo.

Many years ago, fresh out of nursing school, I was in charge one night, with no other RNs on the unit. We had an “active GI bleeder” who needed hourly boluses of either ice water or iced milk through an NG tube. (Yes, the standard treatment at that time was gruesomely uncomfortable for the patient, and in later years determined to be counterproductive.) I had more than a dozen other patients to care for, but everyone got their meds and, miraculously, the bleeding man made it through the night.

When my supervisor made rounds at the end of the shift, I reported that all was well and that my critical patient had survived. Her only response: “Mrs. Todd! There is blood on your shoes!”

This senior nurse, standing there in her starched whites and impeccable shoes, didn’t recognize that I had feared I would be inadequate to the task, or even acknowledge my pride as a brand-new nurse in actually saving someone’s life. In retrospect, I can’t help wondering if her choice to focus on a superficial fact, irrelevant to the crisis, could be interpreted as an indication that she lacked a certain acuteness of emotional […]

2017-07-17T16:49:20+00:00 July 17th, 2017|Nursing, patient safety|1 Comment