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 Asia […]

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.

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 be […]

AJN News: A Role for Nonmedical Workers, Adult Vaccinations Revisited, Teen Pregnancy Drop, More

AJN’s monthly news section covers timely and important research and policy stories that are relevant to the nursing world. Here are some of the stories you’ll find in our current issue (news articles in AJN are free access):

A community health worker meets with a patient in Baltimore, Maryland. Photo by Francis Ying / KHN.

Nonmedical Workers: A Growing Asset to Communities

Outcomes improve, costs drop, and nurses’ workloads benefit when nonmedical community health workers are available to serve as liaisons between health systems and patients. Programs to train more of these workers are gaining attention in states across the country.

Revisiting the Adult Vaccination Schedule for Tetanus and Diphtheria

Results of a new study reveal that most adults remain protected from the two diseases for 30 years without booster vaccination—and call into question the potential benefits of a modified adult booster vaccination schedule.

Teen Pregnancies, Births, and Abortions Slow

Two new reports show that the birth rate among U.S. teens has dropped to its lowest point in three decades; the percentage of teen pregnancies ending in abortion also reached a historic low. Researchers attribute the downward trend to teens using birth control more often and waiting longer […]

The Debriefing: A Forced Pause After an Unexpected Clinical Loss

Illustration by Barbara Hranilovich for AJN Illustration by Barbara Hranilovich for AJN

The Reflections essay in the July issue of AJN is about the brief required debriefing of a medical team after an all-consuming struggle to save a patient.

“The Power of Paperwork” is written by Amanda Anderson, an experienced nurse who is new to a supervisory role. She remains closely attuned to the emotional experiences of nurses and physicians. Leading her former colleagues as they huddled to examine what might have been done differently with a particular patient, she tells us, she found that her “suit and heels provided no armor.”

Sometimes bad things happen for perfectly obvious reasons. If you don’t turn an incontinent patient, he will develop pressure ulcers. If you don’t always verify your patient’s medication against the order and identifiers, you will likely give the wrong drug to the wrong person at some point. The factors involved in such errors can be complex, of course, but remain fairly easy to trace.

Sometimes, though, people just die. We don’t know why, and if we find out, it’s usually not reassuring. The thoughts that follow these deaths—what if I… ?, should I […]

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