About Guest Author

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

Career Change in 2011? Ask the God of Gates, Doors, and Beginnings

Bust of the god Janus, Vatican museum, Rome

By Peggy McDaniel, BSN, RN, infusion practice manager

I’ve never been much for New Year’s resolutions. I guess it’s because I know I won’t keep them—or at least recognize that my track record has been less than stellar. I’ve made the usual promises to myself: eat less, exercise more, learn a new craft, spend more time reading and less time on the Internet . . . and so on.

It seems as if such promises are made with tongue in cheek—even, possibly, made to be broken. So many resolutions are about self-improvement; I suppose that’s a good thing, except we don’t tend to follow through. The yoga classes I attend are always packed from January 2 through approximately March 15, then attendance slowly tapers back to the usual attendees. Do we feel we’ve been successful if we hang in there for a month, two or three months?

I’m not sure I’ve ever made a New Year’s resolution I really planned on keeping.

According to Wikipedia, the Roman ruler Julius Caesar changed the celebration for New Year’s from March to January 1 in 46 B.C. The day was “dedicated to Janus, the god of gates, doors, and beginnings,” who happened to have a face on both sides of his head. This signified the ability to look back and forward at the same time.

That’s something worthwhile—looking back at what we can and should change while […]

2016-11-21T13:14:29-05:00December 30th, 2010|career, nursing perspective|5 Comments
Read More

‘The Birthplace’: Showcasing a Collaborative Practice Model

By Sylvia Foley, AJN senior editor

Photojournalist Alice E. Proujansky reports in AJN this month on The Birthplace, a collaborative care practice model at Baystate Franklin Medical Center in Greenfield, Massachusetts, where a team of five nurse midwives, three obstetricians, and 35 nurses attend some 400 to 500 births annually. Except for preterm and other higher-risk deliveries, the nurse midwives manage all deliveries and monitor fetal and maternal health. Patients complete detailed birth plans that afford them various care options. Physicians are called in only when necessary; as one nurse midwife told the author, “There’s an awful lot that we can do on our own.”

How well does the model work? The Birthplace has lower-than-usual rates of medical interventions such as episiotomy, epidoral anesthesia, and cesarean section. The patients have greater autonomy and decision-making capabilities. And the practitioners “relish the collaborative approach,” says Proujansky, who interviewed several clinicians and patients for the article; her photographs appear alongside the text and on the December cover. Proujansky’s last piece for AJN, a photo essay on a Dominican maternity ward, appeared in our December 2008 issue; read it here.


Bookmark and Share

2016-11-21T13:14:38-05:00December 21st, 2010|Nursing, patient engagement|0 Comments
Read More

When They Can’t Tell You About the Hurt: Assessing Pain in People with Intellectual or Developmental Disabilities

By Sylvia Foley, AJN senior editor

When S.M., a 47-year-old resident at a facility for people with intellectual or developmental disabilities, started hitting himself in the left eye, his caregivers weren’t sure why. S.M., whose developmental quotient is equivalent to that of a two- or three-year-old, couldn’t tell them. Some thought he was frustrated at not being allowed to drink as much coffee as he wanted; others thought a recent decrease in his medication—quetiapine (Seroquel)—might be a factor. But a chart review revealed that both his father and brother had a history of cluster headaches. Was S.M.’s behavior an indicator of headache pain? How could clinicians best assess him?

In this month’s CE feature, authors Kathy Baldridge and Frank Andrasik provide an overview of pain assessment in people with intellectual or developmental disabilities, summarize the relevant research, and discuss the applicability of the American Society for Pain Management Nursing practice guidelines for assessing pain in nonverbal patients. The guidelines describe various behavioral pain assessment tools, some of which might be useful with S.M. and others like him. Other assessment methods include

a search for pathologic conditions or other problems or procedures known to cause pain; the observation of behaviors that might indicate pain; and the use of proxy reports (also called surrogate reports) by people who know the person best, whether family caregivers or professionals.

S.M. was encouraged to draw himself and what the “hurt” felt like; two […]

2016-11-21T13:14:41-05:00December 14th, 2010|Ethics, nursing perspective, pain management|3 Comments
Read More

Fighting Malaria with Public Health Billboards and Mosquito Nets

By Dawn Starin

The metal billboard in the photo stands in the main marketplace on the island of Bubaque, the second largest in Guinea-Bissau’s Bijagós Archipelago. It depicts a mother and child sleeping under an insecticide-treated mosquito net. Translated into English, the text reads, “Malaria kills more pregnant women and children. Always sleep underneath the mosquito net.” But it’s not clear whether it gets its crucial message across effectively.

Half the global population—about 3.3 billion people—is at risk for contracting malaria, a parasitic infection transmitted by mosquitoes. The disease kills close to one million people each year; 91% of these deaths occur in Africa. A major global campaign, Roll Back Malaria (RBM), was launched in 1998 with a mandate “to implement coordinated action to combat malaria” worldwide; some 500 organizations now take part.

One RBM effort in sub-Saharan Africa (an area that includes Guinea-Bissau) is aimed at getting more people to use insecticide-treated bed nets, since the parasite-carrying mosquitoes are reportedly only active at night. In Africa malaria accounts for one in five deaths in children. 

Pregnant women are also at high risk, as they’re bitten by the mosquitoes twice as often as nonpregnant women. Why? According to a study published in 2000 in the Lancet, pregnant women have a higher body temperature and warmer skin and produce […]

2016-11-21T13:14:46-05:00December 2nd, 2010|Nursing|2 Comments
Read More

What Keeps You Up at Night?

Peggy McDaniel, BSN, RN, is an infusion practice manager and occasional blogger on this site

A recent national survey revealed that nurses as a profession are the most dependent on coffee (the survey was commissioned, in part, by Dunkin’ Donuts, though at least conducted by Harris Interactive). The survey asked 3,600 people about their productivity as it related to coffee consumption. The results are interesting if not surprising. Physicians fall in just behind nurses, and hotel workers hold third place.

While working the night shift early in my career, I got my caffeine jolt from diet soda. Not too many years later I developed a taste for coffee by adding hot chocolate to it, in effect creating “mochas” before they were sold for $3.50 each. I still prefer fancier concoctions such as flavored lattes, but in a pinch can be found clutching a packet of powdered creamer over a black cup of hotel room coffee. Some may venture to compare my progressive caffeine consumption to an addiction, and I can’t totally discount that theory. But if you consider that the top three positions on the survey may require work during the night, is it surprising that those who do these jobs also report some dependence on a stimulant? Since many of us seem to depend on caffeine to perform our […]

2016-11-21T13:15:15-05:00October 18th, 2010|nursing perspective|6 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