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Norovirus, a Formidable and Underappreciated Hazard: What Nurses Need to Know

Norovirus, a highly contagious virus that causes acute gastrointestinal illness, is making its presence known across the United States. Symptoms typically begin 12 to 48 hours after exposure and last one to three days and include diarrhea, vomiting, nausea, and abdominal pain.

During the last half of 2024, the Centers for Disease Control and Prevention (CDC) reported close to 500 norovirus outbreaks, a significant increase when compared to the same time period in 2023. These outbreaks have occurred in health care facilities, restaurants, schools, and cruise ships and are continuing to occur in 2025. Norovirus is also the leading cause of foodborne illness outbreaks in the United States, but it is not simply a foodborne or food contamination issue. In fact, norovirus transmission is more complex—and therefore often underappreciated in its impact on human health, including patients and health care workers.

The vulnerability of health care settings to norovirus.

Based on electron microscopic imagery, this illustration provides a 3D, graphical representation of a number of norovirus virions. CDC/ Jessica A. Allen

Let’s look at some of the reasons why […]

2025-01-10T12:10:31-05:00January 10th, 2025|infectious diseases, Nursing, patient safety, Public health|0 Comments
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The Pain Left Behind: Reflections on a Medical Mission and an Island’s Overwhelmed Nurses

“My family left after the volcanic eruption,” Sister said to me with a heavy heart. “But I asked myself, who will take care of my fellow Montserratians who stayed behind?”

These poignant words reflect the resilience and dedication of the nurses I encountered during my recent medical mission to Montserrat. During my time on the island, I collaborated with cardiologist Icilma Fergus Rowe of Mount Sinai Medical Center in New York City, who returns each year to provide much-needed cardiac care. The team serves over 100 patients in just five days, providing essential cardiac consultations, follow-up visits, and diagnostic echocardiograms, as well as referrals for further treatment or testing in Antigua or sometimes the United Kingdom (UK).

Local nurses under strain.

While many patients waited all year for consultation with our team and our presence was met with gratitude, local nurses who facilitated this care also revealed to me that our visit placed additional strain on the already overwhelmed nursing staff. Now, as I reflect on the benefits brought by medical missions like ours, I remain aware of the poignant reality that when you leave, you leave behind hurting colleagues whose pain stays with you.

The lasting effects of a devastating volcano eruption.

This small island in the Caribbean 25 miles southwest of Antigua, once a thriving community, has faced numerous […]

2025-01-08T10:20:14-05:00January 8th, 2025|COVID-19, disaster preparedness, Nursing, Public health, volunteering|0 Comments
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Who’s ‘the Hospital’? Shared Governance Requires Transparent Organizational Decision-Making

When ‘the hospital’ speaks as a single, unified entity.

Many nurses working in hospitals do not know the decision-makers who affect their job. To patients, visitors, donors, accreditors, and other external constituents, hospital systems benefit from being personified as a single, unilateral-appearing brand.

Photo by Erik Mclean on Unsplash

However, when a decision is said to have been made by ‘the hospital,’ rather than by a specific person in the hospital, such language obscures who made the decision and why it was made. Lack of transparency around decision-making processes may be one reason some nurses feel shared governance models are more ‘lip service’ than genuine shared decision-making.

A common health care structure is a large system in which one main ‘flagship’ hospital serves as a central hub, with smaller branch hospitals/clinics with the same name and branding serving patients in other locations that may not be able to support a large hospital or multiple medical specialties.

For example, imagine a 20-bed rural hospital that is affiliated with Higher Education University, a hospital system with their main urban campus in a city one-hour away. The rural hospital’s affiliation with Higher Education University’s hospital system is important for external constituents. A patient may perceive that they […]

2024-12-09T11:17:04-05:00December 9th, 2024|Nursing|0 Comments
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Recognizing Postnatal PTSD

After the birth of her son, pediatrician Tricia Pil struggled with post-traumatic stress disorder (PTSD). The delivery had been complicated by hemorrhaging, large blood clots, invasive emergency medical care, and fear that she and/or her infant might be dying.

“In the months after my son’s delivery,” she recalled, “it was as if a curtain had descended over my life. In addition to a terrible feeling of numbness, I was haunted by flashbacks and nightmares . . . . Billboards for the hospital where I’d delivered, people dressed in scrubs, pregnant women, . . . and worst of all, my own baby—the sight of any of these could trigger flashbacks and bouts of heart-stopping, sweat-drenched panic.”

Though we typically associate the birth of an infant with relief, joy, and adjustments to a new family member, in some cases the picture is complicated by postnatal PTSD (also referred to as postpartum or birth-related PTSD).

Some women are at higher risk for postpartum PTSD.

Photo by Alexander Grey on Unsplash

Research by Slade and Murphy found that “one-third of women experience giving birth as traumatic, and consequently 3-6% of all women giving birth develop postpartum post-traumatic stress disorder,” adding that many more are likely to have […]

2024-12-04T07:29:16-05:00December 2nd, 2024|Nursing|0 Comments
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The Critical Role of Nurses in Intravenous Fluid Conservation

Image credit: AHVAP.org (Association of Healthcare Value Analysis Professionals)

Baxter International’s North Cove Facility in North Carolina was severely damaged by Hurricane Helene on September 26, 2024. The temporary closure of that facility and production interruption has resulted in significant shortages in intravenous, dialysis, and irrigation fluids and supply disruption impacting health care facilities across the United States. The responsibility to effectively and responsibly manage these critical resources has fallen heavily on the shoulders of nursing teams and health care supply chain professionals.

The crucial role of nurses during shortages.

Nurses are responsible not only for administering IV fluids but also for monitoring fluid needs, assessing patient status, and adjusting plans of care accordingly. When these lifesaving fluids become scarce, nurses must ensure that every intravenous fluid or irrigation product is used wisely, balancing patient safety with resource availability.

Why conservation is essential.

The consequences of IV fluid shortages extend beyond inconvenience. Fluids such as 0.9% normal saline and Lactated Ringer’s are vital in stabilizing patients, hydrating those who cannot take fluids orally and serving as carriers for essential medications. Shortages can lead to critical delays in patient care, increased length of stay, and negative outcomes for patients […]

2024-11-18T13:53:43-05:00November 18th, 2024|climate change, disaster preparedness, environmental health, Nursing, Public health|0 Comments
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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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