The Primary Care Confessions of Traumatized Patients

drawing of patient in waiting room Illustration by Hana Cisarova. All rights reserved.

In this month’s Reflections essay, “The Traumatized Patient,” family nurse practitioner Margaret Adams delves with sympathy into what she calls the “primary care confessions” of a challenging subset of patients. Writes Adams:

I’ve come to recognize patients like you—sometimes by your disturbingly long and detailed allergy lists, but more often by the frequency with which you come in for the same constellation of symptoms: fatigue, headaches, dizziness, general malaise. Something happened to you— maybe years ago, maybe recently—and it left its mark on you in irredeemable ways, . . .

While symptoms often do have underlying physiological causes, Adams is likewise attuned to the emotional subtext behind certain seemingly fruitless patient encounters. And with many specific examples, she makes the case here that the life of trauma plays itself out over time in the body and mind. […]

2016-11-21T13:00:53-05:00October 18th, 2016|Nursing, nursing stories, patient engagement, Patients|0 Comments
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Clara Barton Tour Update: From Mercury as Medicine to Modern Disaster Response

The two Clara Barton Study Tour updates below are from Jean Johnson of the Red Cross National Nursing Committee and Linda MacIntyre, chief nurse of the Red Cross, who are taking in tons of impressions and information at the various tour sites.

Antietam At Antietam

Wednesday, September 28

We’ve found our way to the Pry House Field Hospital Museum near the Antietam battle site as our first stop on the Clara Barton Tour.  Medications used for surgery necessitated fast surgical procedures as ether wore off quickly. This had its benefits.

However, there were toxic medicines used, such as mercury. One surgeon refused to use a mercury-based medication and was discharged from his post. His colleagues weren’t ready to accept evidence-based medicine—it was later confirmed that mercury caused significant damage to tissue. We also learned that soldiers treated in the barn and field did better in recovery than the officers who were cared for in the Pry House. This was because of the fresh air. […]

2016-11-21T13:00:57-05:00October 1st, 2016|Clara Barton 2016, Nursing, nursing history, nursing stories, Public health|0 Comments
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Former Navy Nurse Raises Awareness About the Lingering Effects of Agent Orange

Susan Schnall and a group of children at Tu Du Hospital, Ho Chi Minh City, in 2008. Susan Schnall and a group of children at Tu Du Hospital, Ho Chi Minh City, in 2008.

On August 10, 1961, the United States military first sprayed Agent Orange, a defoliant containing a particularly toxic dioxin compound, in Vietnam. Fifty-five years later, the effects of this and other chemicals linger on. And 48 years after former naval nurse Susan Schnall was court-martialed for protesting the Vietnam War, she visited Vietnam for the first time and witnessed these effects firsthand.

“In all my years in health care, I have never seen children with such severe birth defects,” Schnall said during an interview with AJN. After her court-martial, Schnall went on to have a successful 30-year career in hospital administration. After retiring and visiting Vietnam, she decided she needed to do something about what she witnessed there.

Schnall joined a group called the Vietnam Agent Orange Relief and Responsibility Campaign, made up of American Vietnam Veterans, Vietnamese Americans, social activists, and community leaders. The group aims to educate the public on the repercussions of the chemical warfare used in Southeast […]

2016-11-21T13:01:01-05:00August 15th, 2016|nursing perspective, nursing stories, Public health|0 Comments
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A Measure of Contentment: One Patient’s Daily Ritual

By Annelisa Ochoa for AJN By Annelisa Ochoa for AJN

“A Measure of Contentment,” the August Reflections essay in AJN, describes the daily ritual of a resident in a long-term care facility. As author Nancy Ngaruiya shows us, nurses and other health care providers can sometimes notice, and support, the small pleasures and routines that make life worthwhile for patients.

Of this patient, she writes:

We make our own happiness. We define what makes us content, what actions help us find that happiness. Sometimes the recipe takes just a few ingredients. Even in an environment where freedom is limited, where rules dictate when to wake up and go to bed, what days of the week we will get assistance with a full bath and who will do it, what meals and activities are or are not available, he has defined what makes him content, perhaps even happy.

The patient in question happens to be one of those who often get frustrated, who aren’t always grateful or helpful—those who tend to be labeled as “challenging” or “difficult” by overworked providers. It’s easy to notice only the frustration of people who’ve watched their worlds shrink bit by bit as their freedoms and abilities diminish along with their health. […]

2016-11-21T13:01:02-05:00August 3rd, 2016|Nursing, nursing stories, patient experience|2 Comments
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Dark Water, Wild Winds: Notes of a Flight Nurse

I must see new things
And investigate them.
I want to taste dark water
And see crackling trees and wild winds.
—Egon Schiele

IMG_2650Repatriation

I’m standing on the tarmac in Manaus, Brazil, where there is indeed a wild wind; it blows debris across the runway yet does nothing to stave off the nearly intolerable heat. Sweat soaks my back and drips down the center of my chest. My limbs are heavy with lethargy. The heat index is 110 but it feels much hotter—even the Learjet fails to provide a haven from the equatorial sun.

We’d come to Brazil to repatriate an Englishman who’d been visiting family and was struck down by sudden and severe seizures. He’d spent weeks in the hospital, sustaining scans and diagnostics to pinpoint the cause, and endured the addition of one antiepileptic medication after another.

While the seizures finally ceased, he was left disquieted and uncomfortable, unsure which symptoms were due to the 7 cm brain mass that had been discovered and which were side effects of the myriad of antidotes. By the time we were dispatched for this mission, he was medically stable and ready to go home to deal with the ominous findings. Biopsies awaited and treatments would […]

2016-11-21T13:01:03-05:00July 27th, 2016|career, Nursing, nursing stories, 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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