Nursing Archives - Page 125 of 407

Making Sense of the Breast Cancer Screening Guidelines Controversy

“In a time of uncertainty about breast cancer screening, the role of the nurse in communicating information to patients about screening’s health risks and benefits is more important than ever.”

Few diagnostic rituals loom as large—or generate as much anxiety—as an upcoming mammogram appointment. Until relatively recently, most of the concern surrounding the procedure was about what it might reveal. What most women older than age 40 haven’t generally questioned since routine screening began in the 1980s was whether they should have a mammogram each year.

Confusion for patients and providers.

Sandra Brennan, director of radiology at Memorial Sloan Kettering Westchester, West Harrison, New York, reads mammogram results with a technician. Photo courtesy Memorial Sloan Kettering Cancer Center Graphics Team.

Yet many women, particularly those in their 40s, are now struggling with this very issue. Recent changes in the breast cancer screening guidelines of major organizations have moved away from a population-based approach to screening, which has historically begun at age 40 and been repeated annually for most women.

Based on data from clinical research and cancer registries, the current recommendations reflect an effort […]

Corinne McSpedon, senior editor2018-07-09T07:57:28-04:00July 9th, 2018|Nursing|0 Comments

NPs ‘Move Mountains’

Rear Admiral Susan Orsega, chief nurse officer of U.S. Public Health Service

Last week I attended the annual conference of the American Association of Nurse Practitioners (AANP) in Denver. Yes, I was there for the record attendance (over 5,000) and the record heat wave (104 degrees). As with most large nursing conferences, there were numerous concurrent sessions—but here, many of them were like skills labs, including things not part of most RNs’ skill set, like performing a thoracentesis.

What was also different from other meetings was that the legislative and policy sessions, which were of high interest to me in order to find out how NPs are doing with scope of practice authority, were closed to media. No one could say exactly why.

Audio interview with U.S Public Health Service CNO Susan Orsega.

I did get a chance to speak with the keynote speaker, Rear Admiral (RADM) Susan Orsega, MSN, FNP-BC, FAANP, FAAN, chief nurse officer and assistant surgeon general of the U.S. Public Health Service. She focused on the critical role of NPs in addressing health inequities. She urged NPs to become active advocates to improve health, and, mindful of our Colorado setting, she charged them to “Go, move mountains.” You can listen […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-07-06T08:27:26-04:00July 6th, 2018|Conference reports, Nursing, nursing perspective, Public health|0 Comments

Holding Space for Integrative Medicine in Oncology Care

When the patient distrusts the treatment.

Explaining why chemotherapy is indicated for their treatment to a newly diagnosed cancer patient is part of a day’s work for oncology nurses and physicians. Oncology nurse navigators are no exception—I am relied upon to reinforce patient education and answer questions.

While many patients come to us with the attitude “I’ll do whatever you say, let’s fight this cancer!” others present with a deep distrust of health care. Some of their distrust is justified, a result of corporate greed, Big Pharma, and federal regulations, coupled with misunderstandings of the treatment approval process of insurance companies. Depending on the intensity of these patient conversations, it sometimes feels as if we, the oncology team, are under attack, when it is our intent to help.

Despite good health habits, a cancer diagnosis.

Held / Julianna Paradisi / colored pencil and ink on watercolor paper 2018 – adapted from image author drew during cancer treatment

I was a pediatric intensive care nurse when I was diagnosed with breast cancer. My oncology experience was limited to monitoring young patients with a high risk of tumor lysis syndrome during induction of chemotherapy. The actual chemotherapy was administered by pediatric oncology–certified nurses who knew how to keep the patients […]

Julianna Paradisi, RN, OCN2018-07-02T13:26:59-04:00July 2nd, 2018|Nursing, nursing roles, patient experience, Patients|3 Comments

July Issue: Ketamine Analgesia During Burn Care, Breast Cancer Screening Update, Difficult IV Access, More

“How powerful would it be if every nurse took one action today to improve her or his community’s health?” —Barry Ross, MPH, MBA, BSN, RN, author of this month’s Viewpoint

The July issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: The Efficacy and Safety of an RN-Driven Ketamine Protocol for Adjunctive Analgesia During Burn Wound Care

Because of its unique mechanism of action and lack of association with respiratory depression, ketamine may be an ideal agent for adjunctive analgesia in burn patients. The authors of this study evaluated the efficacy and safety of a practice protocol allowing critical care RNs to independently administer IV ketamine for burn wound care.

CE: Breast Cancer Screening: A Review of Current Guidelines

In light of recent changes to national breast cancer screening guidelines, this article reviews the guidelines of the American Cancer Society, the U.S. Preventive Services Task Force, and the National Comprehensive Cancer Network and provides guidance to nurses as they support and educate patients.

Special Feature: Ethics Champion Programs

The authors, all of whom lead ethics champion programs at their respective […]

Diane Szulecki, editor2018-06-29T08:14:55-04:00June 29th, 2018|Nursing|0 Comments

The Thin Flat Line Between Life and Death

Illustration by Jennifer Rodgers.

A patient has died. His nurse begins postmortem care.

“I tell myself the things I always do—it was his time, we did everything we could. I can hear someone crying outside the room.”

In this month’s Reflections essay, author Kassandra August-Marcucio shares her feelings as she performs the steps of this protocol after a failed resuscitation attempt. We are reminded of each task, of the feelings of guilt that can arise (“I was his nurse and he died!”), of the last contacts with the patient’s family.

“The exaggerated zip of the bag is final.”

Almost every nurse has cared for a patient after the patient dies. Sometimes the nurse and patient have barely met; sometimes the patient is well-known to the staff. Many nurses (most, I hope), whatever their religious or spiritual beliefs, approach postmortem care with some sense of the gravity of the moment of someone’s passing. The “routine” tasks involved take on a slightly different aura than the other tasks of our days. Still, it’s hard not to rush through postmortem care to attend to the pressing needs of other patients.

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