About Guest Author

This author has not yet filled in any details.
So far Guest Author has created 493 blog entries.

Getting Nurses with Substance Use Disorders the Help They Need

“Nurses have distinctive risk factors associated with the work environment that may increase the probability of developing an SUD.”

In my previous roles as the director of the emergency department and pediatric intensive care unit, I worked with nurses who were enrolled in the Intervention Project for Nurses (IPN), which is a substance use disorder (SUD) assistance program.

My colleagues would often ask me why I’d hire anyone who was enrolled in this program. My response was that these are the ones who are getting help and trying to recover. I feel safe with these nurses because I know they are being monitored and receiving treatment—it’s the other nurses that I worry about. […]

2022-10-12T09:33:38-04:00October 12th, 2022|career, Ethics, Nursing, patient safety|0 Comments
Read More

Sickle Cell Disease in Children and Adolescents: Aligning Practice with Guidelines

CDC report points to areas for improvement.

The Morbidity and Mortality Weekly Report (MMWR) released by the Centers for Disease Control and Prevention on September 20, 2022, highlights an important opportunity for nurses to provide evidence-based care to children with sickle cell disease (SCD). The report highlights poor compliance with guidelines recommending that children ages 2 to 16 with sickle cell anemia (SCA)—the most common and often most clinically severe form of the disease—should receive transcranial Doppler (TCD) ultrasound screening and that hydroxyurea (HU) should be offered for all children with SCA ages 9 months and older.

In the past, children with SCD usually did not survive past age 20 because of infections/sepsis and stroke. Children with SCD now can live much longer, into their 40s, 50s, and 60s, as a result of the use of penicillin to prevent sepsis and screening for children at high risk for stroke. According to current guidelines for children and adolescents with SCA, when children are screened for stroke by TCD, those at high risk can be identified and referred for monthly transfusions, a practice that has been found to prevent stroke. In addition, there is much evidence supporting the use of HU, including prevention of severe pain episodes, acute chest syndrome, and hospitalization.

Share this:

2022-09-29T10:59:11-04:00September 29th, 2022|Nursing|0 Comments
Read More

In the Nick of Time: Advance Care Planning in the ICU

Marian Grant, palliative care NP

I’m a health policy consultant for national palliative care organizations and often advocate for advance care planning, a process that helps people with serious illness prepare for future decision-making. I also work as a palliative care nurse practitioner (NP) in an academic medical center where I see the real-life aspects of advance care planning.

I recently saw a patient whose case typifies how advance care planning and policies to support it can work. A middle-aged woman with metastatic breast cancer at our cancer center had been seen the day before by the palliative care NP there. The NP was called to help assess the patient’s new-onset dizziness. While seeing the patient, she also spoke to her about her cancer status and suggested completing an advance directive. According to the NP’s note, the patient’s son, who was there with her, seemed surprised that things were not going as well for his mother as they had hoped.

The ‘Five Wishes’ advance directive.

Later in that same visit, the patient became profoundly hypotensive and was sent to the emergency department and then admitted to the medical ICU. The team there put in a request for a palliative care consult for metastatic cancer. I first saw the patient the next morning. She […]

2022-09-22T10:08:13-04:00September 22nd, 2022|end of life, Nursing, Palliative care|1 Comment
Read More

PPE’s Contribution to the Plastic Pandemic

“It’s estimated that it could take 450 years to completely decompose a surgical mask.”

Personal protective equipment (PPE) is critically important for health care workers; however, use of PPE is also contributing to environmental disaster. The COVID-19 pandemic and the monkeypox outbreak underscore how crucial protecting frontline workers is for their health and for public health at large. What is yet unclear are the environmental implications of our extensive PPE use during the pandemic. Nurses must have prominent voices at the table when discussing the future of PPE and how to deal with waste.

In the United Kingdom alone it was reported that over a period of just 53 days, 748 million PPE items were used in hospitals. In 2020, over 6.76 billion PPE items were distributed in England, three times the usual amount. Several countries reported over a 350% increase in medical waste during the height of the pandemic. During two years of the pandemic, it’s estimated that over 900 million tons of plastic waste was generated.

This ‘plastic pandemic,’ which is now a global threat that has been exacerbated by the COVID-19 pandemic, began in the 1850s when early forms of plastic began replacing natural materials. Despite recycling efforts, over 60% of plastics are estimated to remain in […]

2022-09-20T09:37:57-04:00September 20th, 2022|environmental health, environmental health, Public health|0 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top