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Unseen Struggles: When the Pain of Chronic Illness Meets Disbelief

A friend’s desperation.

Photo by Ben Blennerhassett on Unsplash

It was early in the morning when I received a call from my best friend, who was crying and
distraught. She frantically rattled off her symptoms: “My stomach is on fire, I can’t sleep, nothing is relieving the discomfort, and I’m in excruciating pain.” Although she’d been feeling discomfort for the previous two weeks, at first she’d thought the intensity of her current symptoms might be from food poisoning. Given her not always healthy diet, which she and I had discussed in the past, I too at first thought she might have eaten something that set the symptoms off.

“It hurts so badly I don’t think I can take it anymore,” she told me over the phone. “I can’t stop going to the bathroom.”

She said that despite the severity of her pain, her family just thought she was being dramatic. I could sense her desperation as she sobbed over the phone. Even though she did not want to seek medical attention, I begged her to go to the nearest clinic or hospital and told her I’d meet her there.

Crohn’s disease: When nurses doubt a patient’s pain.

In the emergency department (ED) where […]

2023-09-07T11:14:39-04:00September 7th, 2023|Nursing, nursing perspective, pain management, patient experience, Patients|1 Comment
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Telehealth in Rural Nursing: Embracing Change for Better Patient Outcomes

rural road Photo by Bradyn Shock on Unsplash

When I first heard of telehealth services coming to our rural hospital, no one was a bigger skeptic than I was.

Perhaps the main reason was the way I was educated as a nurse and how I learned to practice as an APRN. Honestly, I am “old school” in every way possible. My first thought was, “This is not good practice; how could it be? Won’t there be shortcuts? How about the lack of a physical exam? How can you properly physically evaluate someone over telehealth? How can you take safe care of patients and avoid missing something that’s potentially life-threatening if you can’t touch them? How could someone a thousand miles away help me way up in the mountains of the Eastern Panhandle? What could they know about the community here and their needs?”

These were just a few of the questions and concerns I had regarding telehealth coming to our rural community access hospital. When we assess our patients, we not only to listen to their heart and lungs, look into their eyes, hear their voice, feel the temperature of their skin, but we connect. We are building trust and ensuring support with looking, listening, and feeling.

The […]

2023-10-03T10:04:41-04:00August 25th, 2023|digital health, Nursing, nursing roles, patient experience, Patients|5 Comments
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Updated FDA Guidance on Blood Donation Screening: Where Are We Now?

Blood donation at Red Cross blood drive Photo by LuAnn Hunt on Unsplash

In July 2022, Velasco et al. brought attention to ongoing and systemic discriminatory policies regarding blood donation in the United States. The Food and Drug Administration (FDA) guidelines specifically targeted individuals who identify as men who have sex with men (MSM). The screening questions specifically asked men if they had sex with other men. A “yes” answer disqualified potential donors from donating blood even if they were in monogamous relationships where both partners were HIV-negative.

In December 2022, the FDA’s commissioned study (ADVANCE) wrapped, and news emerged that the study’s results prompted potential changes in the FDA-required screening policies. In a post on this blog titled Potential Changes to Blood Donation Policies for MSM in the United States, I reported the possible changes.

At the time, although we knew there would be potential change, we did not have full transparency or a final answer. Then in May 2023, the FDA updated the guidance for screening blood donors based on the results of the ADVANCE study. You can review those changes here. However, until August 7, some major blood donation centers, such as the American […]

2023-08-21T10:45:35-04:00August 21st, 2023|Nursing, Public health|0 Comments
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Empowering Nurses: Advocating for Better Health Care Policies and Patient Well-Being

Influencing patient health through advocacy.

Did you know that as nurses we have the power to influence allocation of government funds and the passage of government bills on health care? Through advocacy for federal policy and appropriations (funding), we can influence the health care of our patients. We have a voice that can be used to provide lawmakers with a new perspective on the reasons for supporting health care policy. Government policies and budget allotment affect the health of constituents.  Through legislative action, nurses can make changes that affect the lives of individuals, especially those with chronic diseases, minority background, and economic instability.

Not just for patients but for the community.

The ethical principle of beneficence means to do good. As nurses, we have the responsibility to not only do good towards our patients but to communities, expanding our focus from the nurse–patient relationship to a broader community health lens. Nurses can move from patient advocacy that makes changes for one patient to policy advocacy that makes changes for communities of patients. As nurses, we can discuss disparities seen in health care with legislatures to provide a new and personal perspective on support of different health care laws.

Drawing attention to sickle cell disease.

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2023-08-17T12:50:15-04:00August 17th, 2023|Nursing|0 Comments
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Prioritizing Assessment of Postoperative Movement-Evoked Pain

It hurts to move.

Staja Booker, PhD, RN

It’s 10:00, 15 hours postoperative, and your patient has eaten breakfast and is resting comfortably in bed. You ask the patient, “On a scale of zero to 10, how much pain are you having right now?” The patient replies “zero, as long as I don’t move.” The nurse documents the pain score as 0/10 and continues their rounds.

Most nurses are happy when patients report no pain. What is the nurse missing? The contextual factor called movement.

Several years ago, a research participant told me, “Ain’t no sense in getting up to hurt.” A very simple yet powerful statement began my quest to shift how we understand and assess the dynamics between pain and movement.

The realities are:

  • Movement increases acute pain postoperatively, and most patients are afraid to move even when the importance of ambulation is known.
  • Most patients need some type of pain medication or non-pharmacological intervention to engage in mobility-related activities.
  • Movement and mobility enhance recovery and rehabilitation.
  • Movement-evoked pain is as a major barrier to participating in activity-based interventions.

Movement-evoked pain is an important pain characteristic that describes pain and discomfort during active or passive motion of the affected area. Yet, despite awareness among nurses of the importance of setting function-related pain goals, most of our pain assessments are performed […]

2023-07-31T09:32:18-04:00July 31st, 2023|Nursing, patient engagement, patient experience|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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