A Face in a Village: Remembering a First Encounter with AIDS in Africa

We’d already guessed there was a problem at the health post—we hadn’t received the last several monthly statistical reports. As a Peace Corps volunteer in the Central African Republic in the early 1990s, I reviewed these reports as part of my job at the regional health office. Another part of my job was to join a supervisory team as it traveled over dirt roads to check on health facilities from hospitals down to the village health posts staffed by a single nurse. A few months into my assignment, on our way to the provincial hospital, the team decided to stop by this particular health post to find out why we weren’t receiving reports.

That’s from “A Face in a Village,” the February Reflections essay in AJN by Susi Wyss, the author of a well-received recent novel, The Civilized World (Henry Holt, 2011). Set in Africa, the novel, like this essay, was inspired by the author’s international health career. In this essay, Wyss recalls a vivid first encounter with the ravages of AIDS and the hopelessness it inspired. (Click through to the PDF version for a cleaner read.)—JM, senior editor

2016-11-21T13:10:46-05:00February 8th, 2012|Nursing|7 Comments
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Kudos to Indy for Tightening Human Trafficking Laws Before the Super Bowl

According to Stateline.org (a news site of the nonprofit Pew Center on the States), with the Super Bowl taking place this Sunday in Indianapolis, the state of Indiana has decided to toughen up its human trafficking laws.

“Though it is an honor for Indiana to host the Super Bowl, many sincere voices have brought to light the fact that human trafficking is a shameful practice we can’t ignore,” Indiana attorney general Greg Zoeller said in a statement.

The article notes that sex trafficking during highly publicized events has become an issue for many states with hosting duties. While the Global Alliance Against Traffic in Women, an international advocacy group, claims that the estimates of trafficking cases at previous Super Bowls may have been too high, whether there are 60,000 or six in a given year, any number over zero is too many.

For more info, see our award-winning article on the nurse’s role in combating human trafficking, by Donna Sabella. She also talks about her work in a podcast.—by Demaris Bailey
 
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2016-11-21T13:10:48-05:00February 3rd, 2012|nursing perspective|0 Comments
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The Case of Amanda Trujillo

By Shawn Kennedy, AJN editor-in-chief

Post updated on January 10, 2013; see final paragraph. Amanda Trujillo, MSN, RN, is a nurse who until recently worked at Banner Del Webb Hospital in Sun City, Arizona, until she was fired for, as she claims, just doing what she’s obligated to do as a nurse—specifically, providing a patient information about a surgical procedure in an attempt to support fully informed decision making. (You can read her e-mail detailing her story here. She did not, as she has pointed out in comments, ever attempt to directly obtain informed consent herself.)

Amanda Trujillo

Ms. Trujillo says that, when the patient had a change of heart about the surgery, she requested a hospice consult. After a physician complained that Trujillo had overstepped her scope of practice, the hospital filed a complaint with the Arizona Board of Nursing, which has launched an investigation.

Ms. Trujillo has gone public with her story, sending e-mails and tweets to editors, public officials, bloggers, and the news media. The nursing blogosphere is full of posts with her story—Emergiblog, vdutton’s posterous (which has her attorney’s response to the complaint), and thenerdynurse, as well as a number of others. On January 31, she was interviewed on local television. She makes a compelling […]

2016-11-21T13:10:49-05:00February 2nd, 2012|nursing perspective|42 Comments
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A QI Project to Increase Nurses’ Use of ‘Smart’ Pump Libraries

By Sylvia Foley, AJN senior editor

In January 2009 an independent community hospital in Massachusetts switched from using older, outmoded IV pumps to using “smart” pumps—pumps that have built-in computers with libraries of information on selected drugs and fluids, including predetermined concentrations and volumes with relevant administration limits. Library subsets (called profiles) contain information specific to certain patient populations or care areas. When properly implemented, these devices can be invaluable tools in reducing the risk of medication errors and improving patient safety.

But when the hospital conducted a review, it found that smart pump libraries had been used in only 37% of all smart pump infusions done between January and June. One reason was that no “owner” had been assigned to oversee the implementation process. So the hospital’s nursing quality team (NQT) and pharmacy quality team began collaborating to find ways to increase nurses’ use of the pump libraries.

From July through October 2009 the NQT implemented several interventions. Author Andrew D. Harding describes the project as it evolved and reports on the results in this January CE feature, “Increasing the Use of ‘Smart’ Pump Libraries by Nurses: A Continuous Quality Improvement Project.” […]

2016-11-21T13:10:50-05:00February 1st, 2012|nursing perspective|1 Comment
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Clinic Vision

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

By Ctd 2005, via Flickr

I’ve begun volunteering at a local free clinic. While it’s been rewarding and satisfying, it’s also been fraught with challenges I didn’t expect; I’ve only worked in an ICU, and the assessment skills specific to critical care don’t translate smoothly to the clinic setting. I’m out of my professional comfort zone, and I feel so inexperienced.

Here’s what I’m used to: By the time a patient is admitted to the ICU, they’ve already been “worked up” in the emergency room. Physicians have been assigned and a preliminary diagnosis is in place. The patients are connected to equipment that displays their vital data continuously, on monitors I can see from almost anywhere, and alarms are triggered by any alterations. I’ve got easy access to radiology reports and films, laboratory values, and microbiology reports. The nursing physical assessment is thorough and paramount; I know what I’m looking for, what I’m listening and feeling for, what certain smells indicate, and I trust my instincts. I’m accustomed to not only the forced intimacy that comes with the in-depth physical assessments of critical care, but the technology and data that supplement my assessments, as well.

At the clinic my nursing role is quite different. I sit at a desk. I am […]

2016-11-21T13:10:52-05:00January 26th, 2012|nursing perspective, Patients, Public health|2 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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