Guest Author, Author at Off the Charts

What Is Meaningful Use? One Savvy Nurse’s Take

By Jared Sinclair, an ICU nurse in Nashville who has a blog about health care and technology

If you follow health care news regularly, and yet you still feel unsure what “meaningful use” means and how it will affect your job as a nurse, then you have something in common with even the most knowledgeable people on the subject. Despite the fact that discussion of meaningful use among health care IT and informatics folks has reached a fever pitch since the HITECH (Health Information Technology for Economic and Clinical Health) Act was passed last February, in many ways we are no closer to understanding how it will change health care than when discussion first began.

What do we know for sure? The HITECH Act promises incentive payments to providers and hospitals that use electronic health records in ways that meet a minimum set of requirements called “meaningful use.” That sounds simple enough; however, there isn’t just one set of requirements. The criteria for meaningful use will come in three stages, and the requirements for stages two and three have yet to be determined. This is why your local hospital’s nurse informaticists may be less than enthusiastic about the next five years of their jobs. They bear the responsibility for preparing their hospitals for huge changes—without the luxury of knowing what those […]

Guest Author2016-11-21T13:15:16-05:00October 14th, 2010|digital health, Nursing|1 Comment

Startling Findings about Men’s Awareness of Male Breast Cancer . . .

… and a look at the benefits of dragon boat racing for breast cancer survivors of either sex.

By Sylvia Foley, AJN senior editor

Although breast cancer is far less common in men than in women, being a man doesn’t make one immune to the disease. Yet misconceptions about male breast cancer abound. In this month’s CE feature, Men’s Awareness and Knowledge of Male Breast Cancer, nurse researcher Eileen Thomas reports on a qualitative study of 28 men at higher risk (all had at least one maternal relative who had been diagnosed with breast cancer). The goals were twofold: to learn more about men’s understanding and perceptions of this life-threatening illness, and to elicit information that might guide clinical practice and the development of sex-specific educational interventions.

The study findings are rather startling. Nearly 80% of the participants had no idea that men could develop breast cancer. Fully 100% of the participants reported that none of their primary care providers had discussed the disease with them. Asked how they thought male breast cancer was detected, most participants could name only one symptom (“a lump”); one said, “They find it on the autopsy table.” And 43% reported that being diagnosed with breast cancer might cause them to question their masculinity. One participant stated, “I would feel like my manhood was taken away.” […]

Guest Author2016-11-21T13:15:28-05:00October 5th, 2010|nursing perspective, nursing research, patient engagement|0 Comments

Questions of Priority, Written in Vernix and Blood: Two Poems in ‘Art of Nursing’

By Sylvia Foley, AJN senior editor

Jenna Kay Rindo’s poem “An Ode to My Certified Nurse Midwife” (Art of Nursing, August) brims with the narrator’s gratitude for the clinician who has seen her through a “gloomy complicated gestation” with great skill and compassion. (Art of Nursing poems are always free online—just click through to the PDF files.)

This is no sentimental paean, though. This ode is a gritty read, full of vernix and “unrehearsed pain,” euphoria and shame. The child, we learn, was “conceived completely out of wedlock, / in a rush of holy illicit love.” The narrator at first only wants to know how long she can hide the pregnancy. It’s the nurse midwife whose “jubilant congratulations” never seem to waver, whose “size seven hands covered in / sterile latex” draw the infant’s wide shoulders into the world, and give the young mother courage. It’s an ode, perhaps, to something we strive for but rarely attain: a nonjudgmental attitude.

“It is lucky to live outside the target groups,” begins the narrator of Erika Dreifus’s poem “The Autumn of H1N1” (Art of Nursing, October). She is referring to those considered most at risk for the flu and thus at the top of the list for immunization.

But when she finds herself hemorrhaging and frightened, waiting to be seen by a gynecologist who minimizes her distress, she reveals far more complicated feelings about “the prioritized.” It’s an unusually frank […]

Guest Author2016-11-21T13:15:31-05:00October 1st, 2010|patient engagement|1 Comment

Tubes Don’t Kill Patients, Errors Do

By Peggy McDaniel, BSN, RN. Peggy is an infusion practice manager and an occasional contributor to this blog.

by Lars Plougmann/via Flickr

The headline for a recent article in the New York Times caught my attention: U.S. Inaction Lets Look-Alike Tubes Kill Patients. For me, this conjured up pictures of giant tubes with teeth, wrapping around weak patients in their hospital beds and squeezing them. Although I knew exactly what the article was going to discuss, it bothered me that the tubes were given the reputation of being “killers.” Can tubes kill? I think not. Can they contribute to errors? Certainly.

The article explains that numerous patients have been harmed and some have died because clinicians have connected tubing that should not have been connected. These errors run the gamut from enteral feedings being given intravenously and blood pressure inflation devices being attached to IV lines, to administration of intravenous medications into epidural lines.

However, it remains the clinician’s responsibility to provide safe care. […]

Guest Author2018-03-13T10:51:09-04:00September 10th, 2010|nursing perspective|4 Comments

With Inadequate Staffing, ‘Nonessential’ Care Goes First–Then Patient Safety

A coworker of mine made a medication error a few weeks ago. It was a multifactorial error—the medication had been ordered wrong, labeled wrong, and administered wrong—and was investigated accordingly. That particular nurse was also “tripled,” with two ICU trauma patients and one critically ill medical resident patient. The nurse’s workload wasn’t factored into the documentation or investigation of the error, though, since the nurse manager didn’t consider it relevant. I heard her say, “An extra patient shouldn’t make any difference in the standard procedure for passing medications.”

Guest Author2016-11-21T13:15:51-05:00September 8th, 2010|Ethics, nursing perspective, nursing research, safe staffing|7 Comments

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What Is Meaningful Use? One Savvy Nurse’s Take

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Startling Findings about Men’s Awareness of Male Breast Cancer . . .

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Questions of Priority, Written in Vernix and Blood: Two Poems in ‘Art of Nursing’

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Tubes Don’t Kill Patients, Errors Do

However, it remains the clinician’s responsibility to provide safe care. […]

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With Inadequate Staffing, ‘Nonessential’ Care Goes First–Then Patient Safety