Neither Snow, Sleet, Hail, nor Major Blizzard: Business as Usual for Nurses

By Shawn Kennedy, AJN editor-in-chief

ShawnKennedyThe snowbanks in the New York area are already starting to melt, but it’s worth noting that this past weekend’s massive storm was business as usual for nurses. The New York Daily News carried a story earlier this week of a practical nurse who got a babysitter for her daughter and then walked through the height of a recent blizzard to get to her job at a nursing home.

Chantelle Diabate, who works at the Hebrew Home in Riverdale, New York, walked a mile in the snow and wind to get to work. She has been working there for six months as an LPN and said she knew they’d need her because many staff would be unable to get there. She stayed through the weekend.

by doortoriver, via Flickr by doortoriver, via Flickr

AJN’s publisher, Anne Woods, works every Saturday as a cardiothoracic NP in a hospital near Philadelphia. With the imminent arrival of the storm on Friday afternoon, Woods went to the hospital that afternoon and spent the next 36 hours there as the only NP on duty in […]

2016-11-21T13:01:31-05:00January 28th, 2016|career, Nursing, nursing perspective, Patients|0 Comments
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What to Know About Zika Virus

By Shawn Kennedy, AJN editor-in-chief. Accompanying map via PAHO/WHO.

The media is full of headlines and photos about the recent increase in the number of Brazilian children born with microcephaly, thought to be due to maternal exposure to the Zika virus. If you’re like most nurses, you’ve had family members and friends asking you about it, especially if they’re considering a winter escape to the Caribbean or Mexico. Here are some resources and information to help you stay up to date so you can provide your patients (and families and neighbors) with evidence-based information.

2016-cha-autoch-human-cases-zika-virus-ew-3

Zika basics. Zika virus was first discovered in 1947 in monkeys in the Zika forest of Uganda and the first documented case in humans was in 1952. An outbreak on Yap Island in Micronesia in 2007 showed that it had spread beyond Africa. The virus is spread by the Aedes mosquito, the same mosquito that transmits yellow fever, dengue, and chikungunya.

Outbreaks of Zika have been spreading northward from Brazil through the Americas since 2014. (See above PAHO/WHO map of confirmed cases, 2015-2016.) While most transmission is believed to occur via mosquito bites, according to the CDC, “Perinatal, in utero, and possible sexual and transfusion transmission events have also been reported. Zika virus RNA has been identified in asymptomatic blood donors during an ongoing outbreak.”

Symptoms and course are similar to those of other viruses: […]

2016-11-21T13:01:31-05:00January 26th, 2016|infectious diseases, nursing perspective|0 Comments
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We Want You, or Someone You Know! Tell Us About Nurses Making a Difference

Uncle_Sam_(pointing_finger)Nurses in all settings are doing important work and making a difference, and we want to highlight them and the good work they do. AJN’s Profiles column highlights the diverse ways in which nurses contribute their leadership, compassion, and talent to enhance patient care directly in their institutions or through innovations in policy, research, or education that have had far-reaching impact.

Our profiles include:

We’re inviting suggestions for nurses to feature in Profiles. If you know of a nurse who is doing great work, let us know. Or if you have developed an interesting or unique program, tell us about it. […]

2016-11-21T13:01:32-05:00January 25th, 2016|Nursing|0 Comments
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Ethical Practice with Patients in Pain

Photo @ AJ Photo / Hop Americain / Science Photo Library Photo @ AJ Photo / Hop Americain / Science Photo Library

Pain is difficult to define and hard to convey. The way both patients and clinicians respond to it can be influenced by a multitude of possible biases. This month’s Ethical Issues column in AJN is by Doug Olsen, PhD, RN, an associate professor at Michigan State University College of Nursing. In “Ethical Practice with Patients in Pain,” Olsen summarizes the challenge nurses and other clinicians face in treating patients’ pain:

Responding to a patient’s pain is a fundamental ethical obligation in nursing. However, nurses caring for patients in pain can run into ethical conflicts from both over- and undertreatment of pain. Undertreatment of pain represents a failure to fulfill the core nursing obligation to alleviate suffering—but overtreatment may ultimately harm the patient, contradicting a core nursing value, nonmaleficence. The complex nature of pain complicates efforts to provide treatment that is ‘just right.’ Nurses must understand that complexity if they are to make ethical decisions in the care of patients who experience pain.

[…]

2016-11-21T13:01:32-05:00January 20th, 2016|Ethics, Nursing, nursing perspective, pain management, patient experience|1 Comment
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Nurses and Latent TB Infection

By Betsy Todd, AJN clinical editor, MPH, RN, CIC

Mantoux skin test/CDC PHIL Mantoux skin test/CDC PHIL

Are you “PPD positive”?

In December, a California maternity nurse was diagnosed with active tuberculosis. More than 1,000 people, including 350 infants, may have been exposed. In infants, tuberculosis can be hard to diagnose and is more likely than in newly infected adults to progress to active disease and to disseminate to extrapulmonary sites. Therefore, a course of isoniazid was recommended for each of these exposed infants, as well as for any parents, visitors, or staff who tested positive after the exposure.

Some of the details of this incident weren’t released to the media. In my experience, active infection in a health care worker who has not recently traveled to a TB-endemic area is almost always the result of reactivated latent infection. That was the case in a similar exposure more than 10 years ago, when a New York City maternity nurse exposed more than 1,500 infants and adults to active tuberculosis.

And in three of the largest TB exposure investigations on which I’ve worked, the index cases were nurses in oncology, transplant, and the ED whose latent tuberculosis infection progressed to active infection. In these three cases, neither the RNs nor their own primary care providers connected their persistent febrile respiratory infections with their latent […]

2016-11-21T13:01:33-05:00January 18th, 2016|infectious diseases, Nursing, nursing perspective|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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