About Betsy Todd, MPH, RN

Former clinical editor, American Journal of Nursing (AJN), and nurse epidemiologist

Two Nurses Who Traveled to New York City to Care for COVID-19 Patients

“I’d been watching social media and seeing former colleagues and classmates who were working in New York City. [They were] very, very, burnt out and tired. I couldn’t turn down the opportunity to go and help them.” – Caitlin Doane

In the spring, when New York City was the U.S. epicenter of the COVID-19 pandemic, we watched with increasing concern as hospitals became overwhelmed, nurses and doctors worked long shifts for days on end, and PPE was rationed.

Reports from nurses working under these conditions were often horrifying. (Read one nurse’s story from those early weeks here: https://ajnoffthecharts.com/deserted-note-from-a-young-icu-nurse-as-covid-19-pandemic-intensifies-in-u-s/)

Nurses understood.

Nurses from around the country understood far better than the general public just how dire the situation was in New York City hospitals. Some of them traveled here to help. AJN had the opportunity to sit down (virtually) with two of these nurses after their return home, and their stories are featured in the August Profiles column.

Caitlin Doane, an ED nurse from Ithaca, New York, who comes from a family of first responders, joined a medical mission organized by her hospital to travel downstate to hospitals in the […]

2020-09-03T08:32:20-04:00September 3rd, 2020|Nursing|0 Comments
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The Pediatric Illness PANDAS: Easy to Misdiagnose, Often Overlooked

What would you do if your young, previously healthy and happy child suddenly developed obsessive-compulsive disorder or symptoms of Tourette’s syndrome?

In “PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection,” authors Christine Pabst and Kim Subasic discuss an unusual pediatric illness that, although identified more than 20 years ago, is not well recognized by clinicians: PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection.

PANDAS is characterized by the sudden and dramatic onset of “psychiatric” symptoms such as the ones above, appearing during or shortly after infection with group A streptococcus.

Two factors make PANDAS difficult to diagnose.

  • First, it seems so obviously a psychiatric disorder that psychotropic or other psychiatric medications may be prescribed without further investigation.
  • Second, carrying group A streptococcus without signs of actual infection can also precipitate PANDAS, making it difficult to connect PANDAS symptoms with a previous medical illness.

[…]

2020-08-24T06:27:32-04:00August 24th, 2020|Nursing, pediatrics|0 Comments
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Many in Health Care Have Made Sense of COVID Through Art or Poetry

By Hayley Jasper. All rights reserved.

Since March, AJN has been inundated with COVID-19–related manuscripts from around the world, ranging from prospective feature articles to submissions for this blog as well as our Reflections and Viewpoint columns. Not unexpectedly, we are also seeing many visual art and poetry submissions to our Art of Nursing column as we all try to make sense of this pandemic experience.

Art of Nursing selections.

In the July issue, we feature a drawing and two poems that reflect the times, as well as a reprint of a recent post from this blog.

The drawing, Behind the Front Lines, is by Hayley Jasper, an award-winning artist who is a junior in high school. Hayley’s piece was inspired by her mother, who is an ICU nurse in a COVID-19 unit.

The poem “Alone, surrounded” was written by Dublin geriatrician Shane O’Hanlon. Behavioral health nurse Marianne Broyles wrote the poem “Using Time Wisely During COVID-19.” Here’s a brief excerpt:

And I feel very small, like a field mouse.
It is all I can do to
Blend in and hope the great
Horned owl will pass me over…

We hope both poems will invite […]

2020-08-07T09:58:10-04:00August 7th, 2020|Nursing, nursing perspective|0 Comments
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Smoking, Orthopedic Surgery, and Bone Healing

When assessing a smoker who is scheduled for surgery, most of us will quickly zero in on their potential for complications from anesthesia. But what if the upcoming procedure is orthopedic?

Smoking is a well-known risk factor for osteoporosis and bone fracture, so it makes sense that it can be an issue in bone surgery healing.

In “The Effects of Smoking on Bone Health and Healing” in this month’s AJN, authors Stephanie Niu and Fidelindo Lim review the effects of smoking on bone health and healing and offer suggestions on how nurses might use this information to help people facing orthopedic surgery to quit.

“In addition to posing surgical and postsurgical risks for orthopedic patients, tobacco, nicotine, and other byproducts contained in traditional and electronic cigarettes (e-cigarettes or vaping products) adversely affect overall bone health and impede bone healing.”

Smoking associated with poor postsurgical outcomes.

Research has shown that smoking is associated with postop infection and poor bone fusion. It significantly increases time to union and risk of nonunion, and is significantly associated with poor clinical outcomes after surgery. […]

2020-07-20T09:16:45-04:00July 20th, 2020|Nursing|0 Comments
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Falls in Behavioral Health: Different Population, Different Risk Factors

“I need help in 230A! Mr. Johnson is on the floor!”

(click image to enlarge)

Does your heart still sink when you hear a patient has fallen? We’ve gotten better at preventing falls, but we haven’t eliminated them. They remain one of the most common “incident” reports in hospitals. And did you know that adult behavioral health inpatients have more falls and fall-related injuries than patients on medical-surgical units?

In this month’s Cultivating Quality article, “Preventing Falls Among Behavioral Health Patients,” free until July 20, Stephanie Ocker and colleagues discuss their very successful falls-related interventions on an inpatient behavioral health unit. As they proceeded with their root cause analyses of recent falls, an unusual risk factor stood out:

“Patients frequently walked in the unit’s common area with bath blankets hanging around them and often trailing under their feet. When nurses would ask patients not to walk around with blankets to reduce the risk of tripping, patients would say they were cold.”

[…]

2020-07-06T10:53:28-04:00July 6th, 2020|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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