Guest Author, Author at Off the Charts

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 […]

Guest Author2022-09-20T09:37:57-04:00September 20th, 2022|environmental health, environmental health, Public health|0 Comments

We Haven’t Made You Better: Orthopedic Trauma and Emotional Healing

Learning that healing the body isn’t always enough.

For much of my career as a trauma ICU nurse and orthopedic trauma nurse practitioner, I focused on building my knowledge of pathophysiology and mastering the assessment and procedural skills required to care for trauma survivors. After a decade of practice, I felt like I had entered the “expert” phase of clinical competence described by Dr. Patricia Benner in AJN in 1982.

But I was completely ignorant of a giant hole in my practice. A trauma survivor pointed out this gap during a routine clinic visit. Ms. H was six months removed from an ankle fracture she’d suffered in a motor vehicle collision on her way to work one morning. On exam, she had regained full strength and range of motion, the fracture was healed on radiographs, and her pain was limited to a minor ache after extended activity. She’d healed remarkably.

I told her that she had done an excellent job with her recovery and could resume her life, including going to work. I’ve come to believe that Ms. H’s response to this assertion changed my entire perspective on patient care. “I can’t go back to work,” she said. “Since the accident, I can’t get in a car without having panic attacks.”

I was […]

Guest Author2022-09-16T11:39:37-04:00September 16th, 2022|Nursing, nursing research, Patients|0 Comments

Message from a Concerned School Nurse

Robin Cogan

In case you have not seen the new Centers for Disease Control and Prevention (CDC) guidelines for schools, published on August 11, 2022, here they are: Operational Guidance for K-12 Schools and Early Care and Education Programs to Support Safe In-Person Learning.

Key changes in CDC guidance for schools.

The CDC has chosen the path of least resistance as schools are about to reopen or are in their first few weeks of the new school year. Although the word “prevention” is included in the CDC’s name, this central goal seems to have been removed from these guidelines, including crucial pieces of the mitigation strategies that in the past prevented the school-level spread of the virus:

The recommendation to cohort has been removed—its absence will increase class sizes, removing a layer of mitigation.
The recommendation to conduct screening focused on high-risk activities during times of high COVID-19 spread or an outbreak has been changed, mostly leaving it up to individual districts to determine what constitutes an outbreak, with little guidance from local health departments.
The recommendation to quarantine has been removed, except in high-risk congregate settings. I would suggest that schools are congregate settings. We can quibble about use of the term “high-risk,” but we certainly do have high-risk staff, students, and community members who deserve […]
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Guest Author2022-08-25T09:13:06-04:00August 25th, 2022|infectious diseases, Nursing, nursing perspective, Public health, school nurses|2 Comments

Heat Illnesses: Nursing Essentials from a NYC Emergency Department

As complex as health care may be in an emergency department (ED) setting, the weather and seasonality have added additional variables to that complexity. It is critical that registered nurses in the ED understand the health care trends associated with the weather and seasons. As in many other places, the summer here in New York City is a time when people are more active, spending time outdoors and traveling. This summer we have experienced several stretches with temperature in the high 90 degrees. July recently had a seven-day stretch with temperatures nearing and exceeding 100 degrees in New York. These heat waves can become physiologically unbearable.

Jonathan Nover, MBA, RN

Who is most vulnerable to heat illness?

During these heat waves, it is important to recognize the pockets of vulnerability among us. Older adults are often the most vulnerable because of decreased capacity to thermoregulate in response to changes in temperature. It is also important to consider the effects of heat on the homeless community and people without access to air-conditioned environments. Children are more susceptible to heat illness than adults. Some medications, such as diuretics, and consumption of alcohol and illicit drugs can increase a person’s risk of heat exhaustion. Additionally, individuals who perform strenuous exercise […]

Guest Author2022-08-18T11:39:58-04:00August 18th, 2022|climate change, environmental health, Nursing, nursing perspective, Public health|0 Comments

The 12-Hour Nursing Shift: Preferred by Staff, but Good for Patients?

A new study finds reduced communication skills after consecutive shifts but no clinical deficits.

Twelve-hour shifts have been a mainstay of nursing schedules since they began as a staffing strategy in the 1970s, but debate continues about their effect on nurses’ health and ability to safely care for patients.

Studies have examined both aspects of the issue. Regarding staffing, researchers have found that a majority of nurses and hospital administrators prefer 12-hour shifts as a means to achieve continuity of care, ease of scheduling, and for nurses, work–life balance. Regarding patient care quality, research has shown an association between longer consecutive shifts and more clinical errors.

The latest findings.

A recent study from Washington State University aimed to test the latter. The research team recruited 94 RNs working consecutive 12-hour shifts to examine the cumulative effect of shift work–related changes on sustained attention, cognitive effectiveness, and subjective sleepiness. Participants were evaluated in two 20-minute simulated care situations by other RNs trained to assess performance. Nurses working day and night shifts were randomized across fatigued and rested conditions, defined respectively as having worked three consecutive 12-hour shifts or having three consecutive days off.

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Guest Author2022-07-15T10:14:05-04:00July 14th, 2022|Nursing|0 Comments

About Guest Author

PPE’s Contribution to the Plastic Pandemic

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We Haven’t Made You Better: Orthopedic Trauma and Emotional Healing

Learning that healing the body isn’t always enough.

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Message from a Concerned School Nurse

Key changes in CDC guidance for schools.

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Heat Illnesses: Nursing Essentials from a NYC Emergency Department

Who is most vulnerable to heat illness?

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The 12-Hour Nursing Shift: Preferred by Staff, but Good for Patients?

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