Nursing Homes: A ‘Place No One Wants to Be’

I’m on my way home from Atlanta, site of the 2018 NICHE (Nurses Improving Care for Healthsystem Elders) conference. This organization, housed at New York University-Rory Meyers College of Nursing for the last 26 years, provides education and consultation to organizations to improve the delivery of health care to older adults. It now counts over 700 member organizations in five countries and has been successful in helping facilities implement best practices for providing care to older adults.

Redesigning long-term care.

One of the speakers, Migette Kaup, PhD, from Kansas State University and an expert in designing care facilities, spoke about current efforts to redesign long-term care. She noted that traditional nursing homes, which were designed to mimic hospitals, are “a product no one wants” and a place many people would rather die than go to.

Kaup spoke about the success of the newer “household” model of long-term care, which mimics a home setting rather than a hospital. Key aspects of this model are that it centers around an open kitchen space and is made up of a dedicated staff and small group of residents who live together and implement best practices. Kaup cited successes in decreasing depression and pressure ulcers in low-risk patients, among other parameters. Of course the real goal, as we know, […]

The Invisible Nature of Grief

Most nurses know the stages of grief by heart: denial, anger, bargaining, depression, and acceptance. We know the stages do not occur in an orderly, linear fashion. People flow in and out of each stage, circling back around to earlier stages as needed.

But I’m not aware of anyone discussing the invisible, insulating environment grief surrounds its survivors within. An acquaintance described it like this:

“We had just taken our son off of life-support, and sat with him as he passed. Our entire family had gathered to say goodbye. After leaving the hospital, we went to eat. I sat in the café, marveling at the world outside, that people were going about their daily lives, and I had just lost my son.”

When grieving periods were the norm.

collage by julianna paradisi/2018

A cultural understanding of this phenomena developed during the Victorian era, and still exists in period romance novels: People of means, after suffering the loss of a loved one or recovering from traumatic illness or injury, were sent to live with relatives in the country or at the seaside. There, they had no household responsibilities beyond taking long walks through the forest or along the shore, keeping journals, or sketching. In romance novels, the grieving heroine gets the added bonus of discovering a Fabio-like love to heal […]

It’s Spring. Time to Think about Lyme Disease

Ticks Ixodes pacificus (shown here in CDC image) and Ixodes scapularis are known vectors of Borrelia burgdorferi (Lyme disease)

National data confirm that diagnoses of Lyme disease begin to rise each year during the month of April, then rapidly reach their peak in June and July. Just in time for “Lyme season,” readers can learn more about the disease in “Lyme Disease: Diagnosis, Treatment, and Prevention” in this month’s AJN.

Lyme disease was first recognized in 1975 in Lyme, Connecticut. From 492 confirmed cases in 1982 (the first year in which Lyme was a reportable disease) to more than 35,000 confirmed and probable cases in 2016, the causative organism, Borrelia burgdorferi, has continued to expand its geographic reach. The CE article notes that these numbers may be undercounts and cites analysis of laboratory and medical claims data from 2008 suggesting that the true number of annual diagnoses may actually be between 240,000 to 444,000.  […]

April Issue: Delirium in Hospitalized Children, Lyme Disease Basics, Ostomy Care, More

The April 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: Recognizing Delirium in Hospitalized Children: A Systemic Review of the Evidence on Risk Factors and Characteristics

Among the key findings of this review was that delirium is multifactorial,
related to treatment (such as mechanical ventilation) and to a hospital
environment (such as the pediatric ICU) that deprives patients of normal
sleep–wake cycles and familiar routines.

CE: Lyme Disease: Diagnosis, Treatment, and Prevention

The authors describe the clinical features of Lyme disease, the appropriate use of diagnostic tests, the recommended treatment, and evidence-based strategies for preventing tick-borne diseases nurses can share with patients.

Environments and Health: The Great London Smog of 1952

Over five days in December 1952, smog engulfed London, killing up to 12,000 people. This article discusses the disaster’s impact on human health and subsequent pollution legislation—including the U.S. Clean Air Act—and its implications for nurses today, as dangerous air quality events continue and environmental regulations are increasingly under threat.

Supporting Family Caregivers: No Longer Home Alone: Ostomy Care at Home

The authors offer practical guidance, including an informational tear sheet and an instructional

2018-04-02T09:22:34-04:00April 2nd, 2018|Nursing|0 Comments

‘A Story Bigger Than Himself’: Easter on the Oncology Unit

“Kevin refused to make cancer the meaning of his days. . . . He showed me that the smallest gesture has the possibility to create expansive love. His kindness reminded many of the patients that they hadn’t lost value and worth, no matter how humbled they had been by cancer.”

That’s from the lovely Reflections essay in the new (April) issue of AJN and is written by nurse Barbara Adams. The article recounts a memorable Easter episode on the oncology unit in which a 26-year-old firefighter demonstrates a different kind of bravery and selflessness. […]

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