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Sexual Assault Survivors, SANEs, and the Nonreport Option

Figure 1. Process in the nonreport optionBy Sylvia Foley, AJN senior editor

Until recently, survivors of sexual assault had to make quick decisions about whether to report the assault to law enforcement. Those who chose not to report it weren’t entitled to a free medical forensic examination, and many felt further traumatized by this situation.

The Violence Against Women and Department of Justice Reauthorization Act of 2005 changed this. It added a “nonreport” option, which mandates that survivors be given medical forensic examinations even if they choose not to cooperate with law enforcement or the criminal justice system; states must pay for these medical examinations, regardless. In order to receive certain federal funds, states had to comply by 2009. States have responded in various ways. (Click the image above for an enlarged view of the steps followed in Texas.) But there has been little investigation into the impact of the new provision.

An important question. How has the nonreport option affected survivors, sexual assault nurse examiners (SANEs), and victim advocates? To learn more, Laurie Cook Heffron and colleagues conducted a study in Texas. They report on their findings in this month’s original research CE, “Giving Sexual Assault Survivors Time to Decide: An Exploration of the Use and Effects of the Nonreport Option.” The following abstract offers a […]

2017-07-27T14:47:35-04:00March 14th, 2014|nursing perspective, nursing research|0 Comments
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More Than a Headache: Migraines and Stroke Risk for Women

Photo by author. All rights reserved. Photo by author. All rights reserved.

By Karen Roush, MS, RN, FNP, clinical managing editor

I used to think I was lucky. Most of the women in my family have migraines—awful, vomiting for three days, intense pain migraines. Not me. Oh, I have migraines. But no pain, no vomiting, just a visual aura—squiggly lines and loss of part of my visual field for about 45 minutes and then I’m good to go.

I was thankful that I just had the aura instead of the pain and vomiting. But now the evidence shows that migraine with aura, especially when there is no vomiting involved, is an independent risk factor for stroke, as much as if I were overweight, smoking cigarettes, and walking around with my blood pressure through the roof.

And it’s not just having migraines that places me at greater risk for a stroke. […]

2017-07-11T14:42:45-04:00February 12th, 2014|nursing perspective|1 Comment
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Workplace Discrimination: A Survey Among Newly Arrived Foreign-Educated Nurses

By Sylvia Foley, AJN senior editor

Table 2. Outcome Metrics by Recruitment Model Table 2. Outcome Metrics by Recruitment Model

This country has often relied on foreign-educated nurses (FENs) to ease nursing shortages—and  with more shortages predicted for as early as next year, it’s likely we’ll do so again. A positive workplace environment is a known predictor of staff retention; yet little is known about how FENs experience their jobs. To learn more, Patricia Pittman and colleagues surveyed more than 500 FENs. This month’s original research CE, “Perceptions of Employment-Based Discrimination Among Newly Arrived FENs,” reports on their findings. This abstract offers a brief overview.

Objective: To determine whether foreign-educated nurses (FENs) perceived they were treated equitably in the U.S. workplace during the last period of high international recruitment from 2003 to 2007.
Background: With experts predicting that isolated nursing shortages could return as soon as 2015, it is important to examine the lessons learned during the last period of high international recruitment in order to anticipate and address problems that may be endemic to such periods. In this baseline study, we asked FENs who were recruited to work in the United States between 2003 and 2007 about their hourly wages; clinical and cultural orientation to the United States; wages, benefits, and shift or unit assignments; and job satisfaction.
Methods. In 2008, we administered a survey to FENs who were issued VisaScreen certificates by the Commission on Graduates of Foreign […]

2017-07-27T14:48:52-04:00January 27th, 2014|nursing perspective, nursing research|3 Comments
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Patient Decisions: When You’re Just Not Up to Making the Call

By Karen Roush, MS, RN, FNP, clinical managing editor

Photo by the author Photo by the author

For most patients and in most clinical situations, decision making is and should be a shared process between the patient and the clinician (and often the family). But there are some cases when we, expert clinicians versed in scientific and experiential knowledge, need to make a decision for the patient—not out of some paternalistic idea of our authority or superiority, but because the patient really wants or needs us to take on that burden.

I was six months pregnant with my second child. The pregnancy had gone smoothly, which was a blessing after having delivered my first child 10 weeks premature following two weeks spent in a tertiary care center. That pregnancy had been problematic from the beginning—early bleeding, and then a hemorrhage at five months, at which time they’d diagnosed me with placenta previa. It was one of those pregnancies where you were thankful for each additional day that brought you closer to the nine-month mark.

But this time, everything was going smoothly—no bleeding or cramps, an active baby that ultrasounds confirmed was growing well . . . until one morning in February, when I started with cramps that progressed to pain and a lot of pressure. An hour later, I was in the labor and delivery […]

2016-11-21T13:05:37-05:00January 17th, 2014|career, nursing perspective, patient engagement, patient experience|1 Comment
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What Ever Happened to a Good History?

ky olsen/via Flickr ky olsen/via Flickr

By Karen Roush, MS, RN, FNP, clinical managing editor

What ever happened to a good history? We were taught as NP students that the history portion of the exam was as important as the physical. In fact, in most cases it’s what you learn in the history—from asking the right questions and really listening to the patient’s answers—that gives you the information you need to figure out what is going on. The physical findings either support what you’re thinking or lead you to ask more specific questions.

A good history isn’t just listening to the patient’s answers to your questions; it’s listening to all the information they offer. Take for example, the middle-aged construction worker who takes his lunch hour to come in to the clinic complaining of a cold. He lists the usual symptoms, cough, fatigue, a little shortness of breath, and then as you’re starting the exam he casually mentions that he hasn’t been to a doctor in 15 years.

Someone who’s managed to stay out of a doctor’s office for 15 years and now shows up, on his lunch hour, because of a simple cold? So, you ask some more questions and learn about some chest pressure he attributes to the coughing he’s been doing and about his […]

2016-11-21T13:05:39-05:00January 10th, 2014|nursing perspective, Patients|4 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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