About Betsy Todd, MPH, RN

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

A Sense of Meaninglessness and Disconnectedness: Addressing Spiritual Distress Among Cancer Survivors

“I lost a critical year of my life, and now I can’t move forward. I feel stuck. My life is passing me by, and I don’t know what I’m supposed to do anymore.”

This quote is from a composite case example that focuses on the spiritual distress experienced by some cancer survivors. Treatment may be over with, and the prognosis may be excellent. All signs may point to the probability of a cancer-free future. But after confronting a potentially life-threatening diagnosis, many survivors struggle with a sense of meaninglessness or disconnectedness.

In “Assessing and Managing Spiritual Distress in Cancer Survivorship” in the January issue of AJN, Timiya Nolan and colleagues explore the concept of spiritual distress and its impact on a person’s quality of life.

A topic that often goes unaddressed.

The authors emphasize the need for clinicians to actively screen for this problem and learn how to initiate conversations with patients. Clinicians are often reluctant to raise the issue of spiritual well-being, and thus wait for survivors to voice any spiritual concerns. While this approach is effective in some cases, if the conversation never occurs, the survivor’s spiritual needs may be unmet. […]

2020-01-16T10:15:37-05:00January 16th, 2020|Nursing, patient experience, Patients|0 Comments
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A Matter of Public Health: Physicians Make Case for Vaccinating Immigrants in Custody

For three days last week, physicians from around the country led demonstrations and a vigil outside of Customs Patrol and Border Protection (CBP) facilities in the San Diego area. After receiving no response to their repeated offers to the departments of Health and Human Services and Homeland Security to provide free flu vaccinations to immigrants in custody, the physicians (and a few NPs) had come to the border with donated influenza vaccine to press for a pilot vaccination program. CBP officials finally said they would pass the request up their chain of command.

Preventable deaths, plus a matter of the larger public health.

Three migrant children died in CBP detention centers during last year’s flu season. The last hours of 16-year-old Carlos Gregorio Hernandez Vasquez, who died in May of influenza, were documented on a grim surveillance camera video that recently circulated widely on the Internet. But the issue of influenza vaccination for migrants is not “merely” one of such preventable deaths; it is a  public health issue. This year’s flu season has ramped up in recent weeks, and a “window of opportunity” for vaccinating this vulnerable population is closing.

The CDC recommends that everyone six months of age and older receive influenza vaccination […]

2019-12-19T14:10:39-05:00December 19th, 2019|infectious diseases, Nursing, Public health|1 Comment
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Hematologic Childhood Cancers: An Issue for Kids and Adults

“A diagnosis of childhood cancer is a stressful event. It takes time for families to emotionally process the diagnosis before they can learn how to care for their child as therapy is initiated…”

Photo courtesy of the Children’s Hospital of Michigan.

Essential information for nurses.

In “Hematologic Childhood Cancers: An Evidence-Based Review” in this month’s AJN, author Jessica Lynne Spruit provides an overview of hematologic childhood cancers—among the most common types of cancer in kids—written for nurses who work with kids, teens, and adults. Spruit discusses symptoms, diagnosis, staging, treatment, and longer-term issues, as well as supportive care for both child and family.

The article focuses on acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), Hodgkin lymphoma, and non-Hodgkin lymphoma. A section on survivorship care, with an emphasis on the often-difficult transition from months of intensive treatment to less frequent primary care visits, reminds us to be sensitive to the life-changing nature of any cancer, but especially cancer in kids, for both child and family.

Problems among adult childhood cancer survivors.

We usually think of leukemias and lymphomas as pediatric territory. But today, more children are surviving childhood cancers, and problems related to the cancer itself, or to late treatment […]

2019-12-10T10:48:48-05:00December 10th, 2019|Nursing|0 Comments
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A Nursing Way with Meaning

“I have found that the residents of Johnson Tower teach me more about being a nurse and a human being than you would imagine.”

Despite our seriously malfunctioning health care system, sometimes we are lucky enough to be reminded of the richness of our practice. Most of us experience a bright spot or two on most days—a patient’s condition finally improves, and we know we had a hand in that; we are able to spend some “quality time” to help a patient cope with her illness; a discharged patient returns for a happy visit.

Thriving, not just surviving.

A few of us, though, are lucky enough to have nursing work in which we can thrive, and not merely survive, every day. In this month’s Reflections column, “The Way of Johnson Tower,” nurse practitioner Mark Darby describes his work in an unlikely setting: a medical clinic located in a public housing high-rise. Resources may leave something to be desired—occasional leaks from the laundry above seem to target the clinic’s centrifuge—but his practice is rich and fulfilling.

“All these people, despite their circumstances, teach me more about generosity, perseverance, and hope than I could learn anywhere else.”

[…]

2019-12-02T12:57:58-05:00December 2nd, 2019|Nursing, nursing roles, nursing stories, Public health|1 Comment
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We Can Do More to Prevent Patient Self-Harm in the Hospital

“Phone cords, plasticware, and pens – all items found on a typical hospital unit and all seemingly benign.  Yet unchecked, each can be used by a patient to cause self-harm.”

As our health care system jettisons more and more psychiatric inpatient beds, it seems that the old “medical psych” units are becoming a thing of the past. These were the units where a person with significant mental health problems stayed after surgery, or after a medical event. The fact that these patients had at least two serious health challenges—one mental, the other physical—was routinely acknowledged, and medical psych units were staffed with nurses expert in both types of care.

Self-harm on nonpsychiatric units: a closer look at who and how.

Today, patients with serious mental illness are routinely “housed” on medical or surgical inpatient units. Some of these patients have a history of self-harm, and nonpsychiatric hospital units are not designed to keep them safe.

In “Preventing Self-Harm in the Nonpsychiatric Health Care Setting” in this month’s AJN (free until December 10), Kim Liberatore from the Pennsylvania Patient Safety Authority shares some of her organization’s data on patient self-harm events in nonpsychiatric settings. […]

2019-11-22T09:47:57-05:00November 22nd, 2019|mental illness, 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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