The Pain Left Behind: Reflections on a Medical Mission and an Island’s Overwhelmed Nurses

“My family left after the volcanic eruption,” Sister said to me with a heavy heart. “But I asked myself, who will take care of my fellow Montserratians who stayed behind?”

These poignant words reflect the resilience and dedication of the nurses I encountered during my recent medical mission to Montserrat. During my time on the island, I collaborated with cardiologist Icilma Fergus Rowe of Mount Sinai Medical Center in New York City, who returns each year to provide much-needed cardiac care. The team serves over 100 patients in just five days, providing essential cardiac consultations, follow-up visits, and diagnostic echocardiograms, as well as referrals for further treatment or testing in Antigua or sometimes the United Kingdom (UK).

Local nurses under strain.

While many patients waited all year for consultation with our team and our presence was met with gratitude, local nurses who facilitated this care also revealed to me that our visit placed additional strain on the already overwhelmed nursing staff. Now, as I reflect on the benefits brought by medical missions like ours, I remain aware of the poignant reality that when you leave, you leave behind hurting colleagues whose pain stays with you.

The lasting effects of a devastating volcano eruption.

This small island in the Caribbean 25 miles southwest of Antigua, once a thriving community, has faced […]

2025-01-08T10:20:14-05:00January 8th, 2025|COVID-19, disaster preparedness, Nursing, Public health, volunteering|0 Comments
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Celebrating 125 Years of AJN: And Other Recommended Reading from the January Issue

This month’s cover features a collage of AJN covers spanning the journal’s 125 years in print. See our “On the Cover” column for more on AJN‘s visual evolution through the decades.

The January issue of AJN is now live.

We’re kicking off the new year by celebrating AJN‘s 125th anniversary! Read editor-in-chief Carl A. Kirton’s editorial to learn about the journal’s history and see archival photos.

Also worth celebrating: our annual Book of the Year Award contest winners.

This month’s CE article, “Is Your Outpatient Office Prepared to Manage an Opioid Overdose?” identifies emergency response initiatives that could be adapted to address opioid-related medical emergencies in the outpatient adult treatment setting.

With commonly used traditional passive safety pen  needle (SPN) devices, it can be difficult to observe that the insulin dose has been accurately or fully administered. The authors of “Exploring the Use of Passive vs. Active Insulin Safety Pen Needle Devices in a Pediatric Population: A Feasibility Study” examined nurses’ perceptions about the feasibility of […]

2024-12-31T14:07:36-05:00January 2nd, 2025|Nursing|0 Comments
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Who’s ‘the Hospital’? Shared Governance Requires Transparent Organizational Decision-Making

When ‘the hospital’ speaks as a single, unified entity.

Many nurses working in hospitals do not know the decision-makers who affect their job. To patients, visitors, donors, accreditors, and other external constituents, hospital systems benefit from being personified as a single, unilateral-appearing brand.

Photo by Erik Mclean on Unsplash

However, when a decision is said to have been made by ‘the hospital,’ rather than by a specific person in the hospital, such language obscures who made the decision and why it was made. Lack of transparency around decision-making processes may be one reason some nurses feel shared governance models are more ‘lip service’ than genuine shared decision-making.

A common health care structure is a large system in which one main ‘flagship’ hospital serves as a central hub, with smaller branch hospitals/clinics with the same name and branding serving patients in other locations that may not be able to support a large hospital or multiple medical specialties.

For example, imagine a 20-bed rural hospital that is affiliated with Higher Education University, a hospital system with their main urban campus in a city one-hour away. The rural hospital’s affiliation with Higher Education University’s hospital system is important for external constituents. A patient may perceive that they […]

2024-12-09T11:17:04-05:00December 9th, 2024|Nursing|1 Comment
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Recognizing Postnatal PTSD

After the birth of her son, pediatrician Tricia Pil struggled with post-traumatic stress disorder (PTSD). The delivery had been complicated by hemorrhaging, large blood clots, invasive emergency medical care, and fear that she and/or her infant might be dying.

“In the months after my son’s delivery,” she recalled, “it was as if a curtain had descended over my life. In addition to a terrible feeling of numbness, I was haunted by flashbacks and nightmares . . . . Billboards for the hospital where I’d delivered, people dressed in scrubs, pregnant women, . . . and worst of all, my own baby—the sight of any of these could trigger flashbacks and bouts of heart-stopping, sweat-drenched panic.”

Though we typically associate the birth of an infant with relief, joy, and adjustments to a new family member, in some cases the picture is complicated by postnatal PTSD (also referred to as postpartum or birth-related PTSD).

Some women are at higher risk for postpartum PTSD.

Photo by Alexander Grey on Unsplash

Research by Slade and Murphy found that “one-third of women experience giving birth as traumatic, and consequently 3-6% of all women giving birth develop postpartum post-traumatic stress disorder,” adding that many more are likely to have […]

2024-12-04T07:29:16-05:00December 2nd, 2024|Nursing|0 Comments
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Wound Debridement: And Other Recommended Reading from AJN’s December Issue

This month’s cover photo shows a surgeon performing a total knee arthroplasty. See our “On the Cover” column for more.

The December issue of AJN is now live.

This month’s CE, “Evidence-Informed Nursing Clinical Practices for Wound Debridement,” provides nurses with a wound management framework, an overview of wound debridement options based on the potential for wound healing, and scope of practice considerations for developing a plan of care.

Two Original Research articles in this issue explore aspects of care following orthopedic surgery:

Various types of water can be used to flush enteral feeding tubes, but which type of water is best supported by evidence? Read

2024-11-21T10:01:50-05:00November 21st, 2024|Nursing|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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