nursing research Archives - Page 17 of 39

Noise in the ICU: Terminology, Health Effects, Reduction Strategies, and What We Don’t Know

By Jacob Molyneux, AJN senior editor

via Wikimedia Commons

I woke up this morning, as I do every morning now, to the sound of pile driving at a large construction site a block and half away on the Gowanus Canal. It shakes the earth and reminds me of the forges of evil Sauron in one of the Lord of the Rings movies. I once had a dog lose a good bit of hair when there was a pile driver for several months in the lot behind another apartment in Brooklyn.

The negative physical and emotional effects of excessive noise get an occasional mention lately in health reporting, but in New York City or along the remotest forest lane, the forces of quiet can seem to be in rapid retreat before an army of leaf blowers, all-terrain vehicles, diabolically amped-up motorcycles, huge TV sets, garbage trucks, helicopters, and the like.

Lest I sound like a total crank (I do have useful noise-cancelling headphones plus an Android app that offers such choices as white noise, brown noise, burbling creek, steady rain, crickets, and soothing wave sounds), there’s a reason for the preamble. Florence Nightingale herself called unnecessary noise “the most cruel absence of care which can be inflicted either on sick or well,” as is pointed out by the University of Washington researchers who wrote the latest installment of our column Critical Analysis, Critical Care.

Jacob Molyneux, senior editor/blog editor2016-11-21T13:04:45-05:00May 16th, 2014|nursing perspective, nursing research|0 Comments

Nurses Week: Time to Celebrate (Not Denigrate) Nursing’s Worth

By Maureen Shawn Kennedy, AJN editor-in-chief

So, on the cusp of Nurses Week, the week when Americans are encouraged to think about the value that nurses bring to health care, readers of the New York Times were treated to an op-ed written by physician Sandeep Jauhar. According to the byline, Jauhar is a cardiologist and the author of an upcoming memoir about his disillusionment as a physician. The title of the piece was “Nurses Are Not Doctors.” While the author makes sure to reassure us that he thinks nurse practitioners (NPs) have a valuable role to play in health care, he makes the usual charge that NPs are not qualified to practice primary care without physician supervision.

Jauhar conveniently ignores the many studies that have refuted this argument, while basing his case largely on weak anecdotes and one study from 1999 that showed NPs ordered more diagnostic tests. His conclusion: the NPs in the study ordered too many expensive tests because they lack the experience and knowledge of physicians (he concedes in passing that “there are many reasons the NPs may have ordered more tests”). I can’t help thinking that this piece’s publication was purposely timed to take some of the shine off Nurses Week.

I’m surprised that the Times published such a weak letter. First, […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-03-28T10:24:54-04:00May 5th, 2014|career, nursing perspective, nursing research|4 Comments

If You Really Want to Get That Letter Published

By Karen Roush, PhD, RN, FNP, AJN clinical managing editor

via Wikimedia Commons

We love getting letters to the editor . . . really . . . whether it’s to agree or disagree, applaud or admonish. With some articles we actually feel a sense of excited anticipation—this should get some letters!—not because we like to create controversy (though we don’t shy away from it either when there’s something important at stake), but because we want to create dialogue among our readers.

That’s what the Letters to the Editor column is for: to add to the conversation by pointing out nuances, adding support from personal experience, expressing a dissenting view of a topic, or offering corrections or clarifications.

A good letter to the editor contains:

• a point of view
• a sense of the writer and why they were moved to write a letter
• additional information that clarifies, corrects, or enhances the original text (and the evidence backing it up)
OR:
• a reasoned, respectful argument (and the evidence to back it up) against some aspect of the original text
OR:
• a narrative that gives a clearer sense of the human implications of the original text

These are the main criteria we look for in the letters we receive.

We are glad when you enjoy an article or are pleased to see the […]

Guest Author2016-11-21T13:04:53-05:00April 28th, 2014|career, nursing research|0 Comments

The Power of Imagination: Helping Kids with Sickle Cell Disease to Cope with Pain

By Sylvia Foley, AJN senior editor

Many people with sickle cell disease suffer from both acute and chronic pain, which can be severe. Although the exact mechanism isn’t known, the pain is believed to result when sickled erythrocytes occlude the vascular beds, causing tissue ischemia. Such pain, which often begins in early childhood, arises unpredictably. Although some pain crises may require ED visits, hospitalization, opioid treatment, or a combination of these, most are managed at home. Yet little is known about at-home pain management in people with sickle cell disease, especially children.

Table 2. Changes in Self-Efficacy, Imaging Ability, and Pain Perception in School-Age Children After Guided Imagery Training

Cognitive behavioral therapy (CBT) has shown promise in helping patients with other chronic illnesses to cope with pain. Cassandra Elaine Dobson and Mary Woods Byrne decided to test guided imagery, a form of CBT, among children enrolled at one sickle cell treatment clinic in New York City. They report on their findings in this month’s original research CE, “Using Guided Imagery to Manage Pain in Young Children with Sickle Cell Disease.” The abstract below offers a quick overview; if you click the image above, you’ll see an enlarged view of one table showing key results.

Objectives: The purposes of this study were to test the effects of guided imagery training on school-age children who had been diagnosed with […]

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Guest Author2017-07-27T14:47:16-04:00April 2nd, 2014|nursing research, pain management, patient engagement|0 Comments

AJN’s April Issue: Sickle Cell Anemia, Telehealth, Systematic Reviews, FOAMed, More

AJN‘s April issue is now available on our Web site. Here’s a selection of what not to miss, including two continuing education (CE) articles that you can access for free.

Coping with pain in sickle cell anemia. Our April cover features a painting of red flowers in a vase. But on closer inspection, you might notice that the flowers are actually red blood cells, painted by a young girl who suffers from sickle cell anemia. Afflicting about 90,000 to 100,000 people in the United States, sickle cell disease often causes acute and chronic pain syndromes described as being on par with cancer-related pain. Cognitive behavioral therapies, such as the use of guided imagery, have shown promise in changing pain perception and coping patterns in people with chronic illnesses. April’s original research CE article, “Using Guided Imagery to Manage Pain in Young Children with Sickle Cell Disease,” suggests that this technique can be effective for managing pain in school-age children with the disease.

Implementing advances in telehealth. New technologies such as remote monitoring and videoconferencing often emerge before a facility is ready to efficiently integrate them. Sometimes referred to as disruptive innovations, these technologies, while convenient and easy to use, may not be readily accepted. “Telehealth: A Case Study in Disruptive Innovation” discusses the many applications of telehealth, a means of delivering care that is […]

Amy M. Collins, managing editor2016-11-21T13:05:06-05:00March 28th, 2014|nursing perspective, nursing research|0 Comments