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Preventable and Aggressive Care for Cancer Patients: To the Bitter End

There have been a couple of recent studies that confirm what I have observed as a palliative care nurse practitioner (NP) in an academic medical center: that there’s still a tendency to pursue very aggressive care with older people with cancer. While every situation is different, the evidence shows that people with cancer could also benefit from palliative care and advance care planning to make sure they’re getting the best and right care for them.

Palliative care could prevent many ED visits.

The first study to catch my eye as a former ED nurse was Trends and Characteristics of Potentially Preventable Emergency Department (ED) Visits Among Patients With Cancer in the US. This study reviewed data on almost a billion (854,911,106) ED visits, of which 4.2% were made by patients with cancer. The mean age of those patients, not surprisingly, was 66. The study found that more than half of ED visits among patients with cancer, 51.6%, were identified as potentially preventable, with the absolute number of potentially preventable ED visits increasing substantially between 2012 and 2019.

The authors concluded that this highlights “the need for cancer care programs to implement evidence-based interventions to better manage cancer treatment complications, such as uncontrolled pain, in outpatient and ambulatory settings.”

This […]

Relaxing: An Undervalued Skill as a Nurse

Image copyright Tanya Parker

Taking the art of collage seriously.

I recently attended an art workshop at the Biggs Museum of American Art led by artist Melissa Sutherland Moss, whose work is currently on exhibit there. The award-winning artist shared her process and guided participants in creating collage art based on the themes of self-identify and reflection. With participant permission, the artwork was featured in an exhibit at the museum as a part of the Dover Citywide Black History Celebration in February.

This was not the same collaging I remembered from elementary school years. There was nothing “juvenile” about the process. In fact, the only thing that invoked nostalgia was the use of the materials (magazines, photos, and other resources) to bring my vision to fruition. My end product, shown above, was titled “Relaxation.”

A visual reflection on relaxation.

Nursing is a caring profession. We know well how to serve others (patients , families, colleagues, students), but often neglect to care for ourselves. There’s an underestimated strength in the ability to rest, “relax,” and recharge. Self-care is often an afterthought or a never-thought. It’s frequently downplayed and or dismissed. However, with self-care we are able to be a better version […]

2023-03-23T09:58:39-04:00March 23rd, 2023|Nursing, wellness|7 Comments

Access to Abortion Medications: Why Should Nurses Care?

She sat in my office, tissue in hand, tears rolling down her cheeks as she tried to process the news I’d just confirmed: she was pregnant, and really, really needed to not be. She was living in her brother’s small house, her seven-year-old son with her, sleeping on a sofa while trying to put her life back together after a divorce. She had chronic kidney disease, and had been told that another pregnancy could cause kidney failure.

She didn’t really believe abortion was a good thing to do, but also couldn’t imagine that God would want her to go on dialysis. For the most part I listened, asking a question here and there to help her clarify her own thoughts. Ultimately, she decided on an abortion, so I referred her to the closest clinic, several hours away from the rural town we met in.

Medication Abortion in the United States

By Robin Marty/Flickr Creative Commons

Even before the Dobbs decision overturning Roe v. Wade, abortion was difficult to access for people living in many regions of the country. TRAP (targeted regulation of abortion providers) laws forced many clinics to close, making abortion access challenging if not impossible even though every American was legally, constitutionally permitted to make her own decision.

Last year, as the […]

A Curricular Blind Spot: Skin Assessment for Patients with Dark Skin Tone

The Time to Build Assessment Skills for Dark Skin Tone is Now

As a faculty member teaching prelicensure nursing for nearly three decades and a former adult critical care nurse, I have had the opportunity to review countless nursing textbooks. Unfortunately, we have a serious curricular blind spot regarding caring for and assessing conditions in dark skin tone patients. It is time we provide equitable education and patient care to all human beings of all skin tones for safe and effective care.

Development of Descriptive Terms for Dark Skin Tone Conditions

Consensus is needed for new and revised standard definitions of the terms and protocols currently in nursing textbooks and teaching-learning materials to incorporate dark skin tone. Terms such as erythema, pink, pallor, and non-blanching are some of the terms that need new descriptions reflecting how they represent or manifest in dark skin tone.

In addition, skin assessment protocols, guidelines, images, and overall protocols—pressure injury stages, the skin color aspect of the […]

2023-03-13T09:11:11-04:00March 13th, 2023|equity, Nursing|3 Comments

Tuning in to Humor in Nursing

1. Nurses Don’t Have to Make This Stuff Up

Photo by Kah Lok Leong on Unsplash

During a fire drill the nurse, Kathryn, was closing doors to patients’ rooms. An 86-year-old patient was talking on the phone to her daughter when Kathryn reached her room. As Kathryn started to shut the patient’s door, the woman asked, “What’s that ringing noise?”

“Don’t worry,” Kathryn said. “We’re just having a little fire drill.”

As she was leaving, Kathryn heard the woman tell her daughter, “No, everything’s just fine, dear. The hospital’s on fire but a nice little nurse just came to lock me in my room.”

Having worked as a nurse, as well as having interviewed hundreds of nurses over the years, I can attest that you don’t have to make this stuff up. Yet nurses from coast to coast right now are telling me, “There’s nothing funny happening in my life.”

Having studied the brain and humor for decades, I can tell you that if that is your belief, that will also be your reality. Telling yourself there’s nothing funny around you will wire your reticular activating system to show you just that—nothing funny.

Even during times of chaos—overwhelming patient census, lack of resources, staffing shortages—humorous material is […]

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