About Guest Author

This author has not yet filled in any details.
So far Guest Author has created 494 blog entries.

Depression in Older Adults: A Nurse’s Guide

By Sylvia Foley, AJN senior editor

‘Mourning Old Man’ by Vincent Van Gogh

“It is a misconception that depression is a normal, inevitable part of aging; it is not,” writes author Cynthia Cahoon in this month’s CE, “Depression in Older Adults.” Depression affects an estimated 15% to 19% of Americans ages 65 and older living in a variety of settings, yet it often goes unrecognized and untreated. Granted, recognition can be challenging, in part because many symptoms of depression are also common to other illnesses seen in older adults. As Cahoon points out, though, there is also “abundant evidence that depression in older adults is treatable, perhaps in as high as 65% to 75% of cases.”

The article provides an overview of depression in older adults and outlines its pathophysiology and disease types. Known risk factors for this population include the following:

  • chronic medical conditions
  • polypharmacy
  • multiple losses
  • functional decline (physical, cognitive, or both)
  • personal or family history of depression
  • social isolation
  • substance abuse or dependence

According to Cahoon, a majority of adults with depression will present for treatment of physical conditions, rather than for a mood disorder. So it’s important to assess each patient’s mood, regardless of presenting symptoms. Several brief, validated screening tools exist, and busy nurses have several options. One tool, the Whooley Depression Screen, takes less than five minutes to administer and asks just two questions:

1. During the past month, have you often been bothered […]

2017-07-27T14:53:25-04:00November 6th, 2012|Nursing|1 Comment
Read More

‘No One Ever Put the Puzzle Pieces Together’: A Nurse’s Guide to Celiac Disease

By Sylvia Foley, AJN senior editor

Wheat spikes by Dag Endresen, via Flickr

If you’ve thought that celiac disease is just another disease-of-the-moment that few people actually have, this month’s CE by McCabe and colleagues, “Celiac Disease: A Medical Puzzle,” might make you reconsider. The disease is an autoimmune genetic illness that typically targets the small intestine, and it’s caused by an intolerance to ingested gluten, a complex protein found in wheat and certain other grains. Until recently, celiac disease was considered rare; but widespread serologic testing has indicated otherwise. Experts estimate that up to 1% of the U.S. population—more than 3.1 million people—are affected.

Yet celiac disease remains widely underrecognized. For one thing, clinicians are still being taught that it’s a childhood illness, although onset can occur at any age; for another, disease presentation is highly variable (there are more than 200 associated signs and symptoms). All of the article’s six authors have themselves “either personally endured or witnessed the misery of misdiagnosis.” To help raise awareness, they offer several illustrative stories, including this one:

I am a registered nurse. I was treated for irritable bowel syndrome for more than 10 years. Although I was very careful with my diet, I never seemed to get better and felt sick most of the time. One day, I was admitting an elderly woman to home care and was reviewing her many diagnoses. She told me about her celiac disease and the symptoms she’d experienced. As […]

2017-07-27T14:53:00-04:00October 5th, 2012|nursing perspective|0 Comments
Read More

Practically a Nurse: Life as a New Graduate RN

By Medora McGinnis, RN, whose last post for this blog was “Don’t Cling to Tradition: A Nursing Student’s Call for Realism, Respect.” Medora is now a pediatric RN at St. Mary’s Hospital in the Bon Secours Health System, Richmond, Virginia, as well as a freelance writer. As a nursing student she was the Imprint Editor for the National Student Nurses Association.

Life as a new graduate RN has been . . . confusing. While my peers seem to have it all together, for the last five months since graduating I’ve been perplexed—what do I do with myself, if I don’t have to stress out and study everyday? Well, of course I have my five kids to keep me busy, an amazing new job as a pediatric RN, and my husband who almost forgot what I look like.

Still, I feel like I should be cramming for something, memorizing something, or at least triple-tasking. I’m stressed that I’m not stressing out. Maybe I just dreamt that I graduated . . .

Here is a little of my backstory: I graduated in May from a three-year diploma program, as part of the very last class in that historic Virginia program, Bon Secours Memorial College of Nursing. It is now a four-year BSN program. They are affiliated with the large health […]

2016-11-21T13:09:13-05:00September 25th, 2012|career, Nursing, students|2 Comments
Read More

A Nurse and Mother on Dialing Back the Risk in Football

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

One Monday afternoon when my son Bryan was a senior in high school I got a call from him. He had hurt his back during football practice and was in so much pain he couldn’t move to get into his car. I rushed over to the field and found him standing, tense and still. When I lifted his shirt to look at his back, I gasped. The entire lumbar area was rounded and swollen out to the size of a grapefruit. At the hospital tests revealed he had a large hematoma, no critical damage done. The first question Bryan had for the doctor—“Can I play on Saturday?”

All week he insisted he could play and I insisted he couldn’t. His arguments never let up—he was quarterback and Saturday’s game was with an archrival. There wasn’t time for the backup quarterback to learn the plays, his team depended on him. Finally I made a bargain. We would go see his physician, whose judgment I trusted, and we would both respect his opinion, whichever way it went.

He played. One of the coaches wrapped his back in layers of padding with an ACE bandage and out he went. It was a brutal game. As determined as he was, the pain still slowed him […]

2016-11-21T13:09:20-05:00September 14th, 2012|nursing perspective, Public health|1 Comment
Read More

Best Care at Lower Cost: New IOM Report Spotlights Crucial Role of Nurses

By Mary D. Naylor, PhD, FAAN, RN. Dr. Naylor is the Marian S. Ware Professor in Gerontology and director of the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing. She is also the National Program Director for the Robert Wood Johnson Foundation program, Interdisciplinary Nursing Quality Research Initiative, aimed at generating, disseminating, and translating research to understand how nurses contribute to quality patient care. She was appointed to the Medicare Payment Advisory Commission in 2010. 

Building on the Future of Nursing report’s call for nurses to fully engage with fellow health care professionals, a new report from the Institute of Medicine, Best Care at Lower Cost, calls on nurses and others in the health care system to apply emerging tools, technologies, and approaches to yield lower costs and better health outcomes. I had the great fortune to serve as a member of the study committee.

The complexity problem. The report couldn’t be more timely or relevant, particularly for nurses and the patients they serve, given the complexity of the current health care system. Administrative and workflow inefficiencies limit hospital nurses from spending more than about 30% of their time on direct patient care. With increasing specialization, modern medicine now includes nurses in more than 50 specialties. To successfully coordinate a patient’s care, nurses need to communicate and collaborate with patients, family caregivers, physicians, pharmacists, social workers, and many other team members.

The complexity […]

2016-11-21T13:09:23-05:00September 6th, 2012|career, nursing perspective|1 Comment
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