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PTSD and Falls: For the Elderly, a Lost Sense of Safety and Control

Jack lowers his head and presses his temples with his thumbs. He whispers, “Am I going crazy?”

In the weeks after his fall and trip to the emergency department, something has gone painfully awry. He’s been having episodes of anxiety when transferring from bed to chair as well as difficulty sleeping. His once unflappable optimism has been blunted by intrusive memories and ruminations about the fall and a sense of foreboding about the future.

Psychological Aftereffects of a Fall

Though he sustained no serious injury and had been quickly returned to the assisted living facility where he lives, the fall has left him with symptoms of posttraumatic stress disorder (PTSD). Most health care professionals are unaware that falls in the elderly can cause posttraumatic stress symptomatology, acute stress disorder, even PTSD. Indeed, in some settings falls occur frequently enough to insulate nurses and other medical staff from the awareness of how terrifying such an event can be or how it can undermine one’s sense of safety and control, particularly when it results in injury and/or invasive medical treatment.

Although Jack was under hospice care at the time of his fall, the facility sent him to the hospital because of its policy on ruling out head injury. Most hospices and facilities have protocols governing their response to falls. These typically include timely […]

2017-07-19T07:34:30+00:00 July 19th, 2017|Nursing|2 Comments

Night Watch

Editor’s note: In this tightly observed guest post, a nurse visiting a sick family member experiences the hospital as a kind of foreign country.

Eileen McGorry, MSN, RN, worked as a registered nurse in community mental health for over 30 years. She currently lives in Olympia, Washington, with her husband Ron.

The walkway is hard, the concrete cold, and I am immersed in darkness. Then there is the swish of the hospital doors and whispery stillness. The light over the reception desk shines on a lone head, bent over a book. A clipboard is pushed toward me. The paper on it is lined with names, some boldly printed, others scribbled, the letters unrecognizable. The spacious lobby is filled with individual groups of soft stuffed chairs and love seats. All of it quiet and empty. Over the chairs and sofas, the black of the midnight hour is changed into twilight.

I remember the bustle of the area at midday. Families gathered together, eyes searching the crowd for the green scrubs of surgeons. “She will live,” they say to some, and to others, “We will wait and see.” The frenzy of the day over, the empty chairs wait for tomorrow.

I sign my name in script. I use the old Catholic school script. The script preached by my mother, who is upstairs recovering from heart surgery. I walk past the chairs along walls so white they […]

Parents as Mentors: Observations of a Peds/NICU Nurse

By Jody Holland, MN, RN, neonatal ICU and pediatrics, St. Charles Medical Center, Bend, Oregon

The strength of parents.

Hospital, by boliston / via Flickr

We have all had and need mentors at some time in our career. The most influential mentors to me have been the parents of the infants and children who have been placed in my care. Parents do not ask for their child to be born early or develop a devastating illness, but these parents summon great strength when it’s needed.

I have countless memories of episodes that have made me pause and reflect on the courage and resolve of parents. I remember a family who stood by their child during a resuscitation and were an integral part of the decision-making process to end the resuscitation. This was long before research documented the benefits of this type of parental involvement.

Or the time when the parents of a child with a devastating head injury fulfilled their promise to their child to get married. In addition, the child also wanted to be the flower girl. They were married at their child’s bedside. The ICU staff followed their wishes and dressed the girl in an outfit of their choosing, placed flowers in her hair, and made a bouquet. The ceremony went off without a hitch—and I believe it gave the parents some […]

2017-05-01T09:29:17+00:00 May 1st, 2017|Nursing|0 Comments

Earth Day 2017: An Important Role for Nurses

By Barbara Polivka, PhD, RN, FAAN, professor and Shirley B. Powers Endowed Chair in Nursing Research, University of Louisville, Kentucky

“… the symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different—of the want of fresh air, or of light, or of warmth, or of quiet, or of cleanliness…”  -Florence Nightingale, Notes on Nursing: What it is and What it is Not (1859).

 

crocus shoots, early spring / Wikimedia Commons

As we celebrate the 46th Earth Day, it’s good to look back.

  • Earth Day was founded by U.S. Senator Gaylord Nelson as an environmental teach-in on April 22nd, 1970.
  • The first Earth Day celebration helped spur the creation of the U.S. Environmental Protection Agency and the Clean Air Act.
  • Earth Day became an international celebration in 1971 when the UN Secretary General talked about it at a Peace Bell Ceremony in New York City.

A time to think about how we affect the environment and are affected by the environment.

Health Care Without Harm (https://noharm.org/) is an international organization promoting environmental health and justice. If you aren’t familiar with Health Care Without Harm I urge you to go to their website to see how health care organizations are decreasing their environmental impact. Health care facilities are:

2017-04-21T08:26:16+00:00 April 21st, 2017|environmental health, Nursing, Public health|0 Comments

The Significant and the Superficial

Libby Kurz, BSN, MFA, RN, works as an OR nurse. Formerly a nurse in the U.S. Air Force, she lives in Virginia with her family. Her work has been published in several literary magazines. To read more of her writing, visit www.libbykurz.com

I often wonder why the world is the way it is. Why, above all other possibilities, do we have two eyes to see, a mouth that tastes, a body that needs food and fluid to sustain itself, but a mind that can entertain thoughts far beyond the realm of the physical world? The more I think about it, the stranger life seems.

People are odd, too. I’m always blown away by our quirks. There’s a surgeon I work with who has to eat his cereal every morning in the shower. He had a shelf built into his shower just for his cereal bowl. One of my coworkers has a pet scorpion and two snakes, but she hates spiders. An acquaintance of mine eats mayonnaise and peanut butter sandwiches.

Working as a nurse provides an environment where these ironies and oddities of life seem even more pronounced. I […]

2017-04-13T12:11:56+00:00 April 13th, 2017|Nursing, nursing stories|1 Comment