Nursing Archives - Page 321 of 407

Six Degrees of Separation: How Close Is Too Close?

By Julianna Paradisi, RN, OCN

I stand in the fluorescent-lit hallway, waiting my turn at the window to pick up two units of blood from the blood bank. Ahead of me, a woman whose hair is swallowed up by a paper bouffant cap wears blue scrubs and hot pink Crocs on her feet. I assume she’s from OR, because of her garb. The blood bank is located in a staff only access area, and the hallway is narrow. Loitering, I feel the same awkwardness I feel standing on a sidewalk while waiting my turn at an ATM. What’s the socially acceptable separation between the person I’m waiting behind and myself? Too much, I block the hallway or the sidewalk for others. Not enough space, and I intrude on the interaction. How close is too close?

On my way back to the clinic, I carry the units of blood in a Playmate cooler marked “Biohazard.” I stand in another hallway waiting for an elevator. It’s flu season, so I hit the “up” button with my elbow to avoid getting virus on my hands. I look around first so visitors won’t see me do it. I don’t care if hospital staff watches. They understand. The elevator door opens, and I get in. After the doors close, the person standing next to me coughs as if expectorating a lung. This is too close.

Back in the clinic, I double-check the first unit of blood with another nurse. […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:13:47-05:00March 15th, 2011|nursing perspective|1 Comment

A Nursing Report That Deserves More Than The Usual Shrug

By Christine Moffa, MS, RN, AJN clinical editor

The IOM report The Future of Nursing: Leading Change, Advancing Health came out this past October, causing a flurry of excitement among some in the nursing world and groans of “big deal” among others. My immediate instinct was to shrug my shoulders and wonder if yet another report will really make a difference at the bedside.

AJN addressed the report and its implications in our December 2010 and February 2011 issues—so I knew it must be very important. But, for some reason, I had assumed it was going to be a dry, unreadable bore. And I put off reading it until recently, when I needed to use it as a reference. And wow, was I in for a surprise! I especially liked the inclusion of real case studies of nurses from different backgrounds and work experience who are making a difference in health care.

It’s inspirational, and I encourage all nurses out there—and anyone with a stake in health care (that’s pretty much everybody)—to take a look. (Tip: I found downloading the PDF version didn’t take long, and it was much easier to navigate than the HTML version.) If you’d like to hear more on the report and what it means to nurses, sign up for our upcoming Webcast […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:13:51-05:00March 14th, 2011|career, nursing perspective, nursing research|5 Comments

Laundry

I remember feeling just as wide-eyed and excited as she looked. And I like having students with me, especially ones who are so teachable that they soak up everything around them like a giant sponge. My student’s willingness to do “everything” served her well, as far as learning experiences go, and she approached tasks without trepidation. She was elated with success (insertion of a nasogastric tube) and mortified with failure (insertion of a rectal tube; she actually vomited). There were moments of fascination (touring the ICU and helping settle in a trauma admission) and boredom (attending a pain management process improvement meeting). There was also frustration; at the end of the day, she ruined her new scrub top with a spill of dark orange rifaximin.

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:13:52-05:00March 10th, 2011|career, students|6 Comments

On the Web: A Tragic Choice, Wasting Berwick, Cost Control, A Nurse’s Comfort Zone

An estimated 60% of American bankruptcies result from overwhelming medical costs. My uncle’s tale illuminates the dual tragedy of suffering catastrophic illness and being uninsured.

Read the rest of this troubling post at The Health Care Blog by surgeon John Maa if you doubt that we need health care reform in this country.

A measure of how unserious we are about fixing the problem of health care quality and costs in the U.S. can be found in reports that Don Berwick, President Obama’s choice to run the Centers for Medicare and Medicaid Services (CMS), continues to have an uphill battle for confirmation, despite being widely acknowledged within the medical community as the best choice for the challenging job.

Since we’re talking policy, there’s an incisive post at the Health Affairs Blog on where our energies should—and should not—be going in controlling costs. Here’s an excerpt:

The current cry to reduce Federal deficits and debt growth by reducing Medicare and Medicaid entitlements is totally missing the key issue: the need to moderate all health care inflation. This should be the time for a national debate on how to best tackle the underlying cost problem, for the sake of our future, the economy, and access to health care.

The June 13-19, 2009 Economist editorialized: “America has the most wasteful […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:13:54-05:00March 8th, 2011|Nursing|1 Comment

Psychiatrists as Therapists: A Vanishing Breed

By Maureen Shawn Kennedy, AJN editor-in-chief

In an article in the New York Times on Sunday, writer Gardiner Harris described how many psychiatrists have abandoned psychotherapy in favor of short consultations and pharmacotherapy; if patients want to discuss their problems, they are referred to a therapist. The main driver of this trend is money—with other, cheaper professionals available to provide therapy with comparable results, insurance companies won’t pay the higher fees most psychiatrists charge. So, instead of seeing 50 to 60 patients a week for the traditional 45-minute session on the psychiatrist’s couch, the psychiatrist can see 1,000 or more patients in a 15-minute, “what’s happening? do you need a medication adjustment? see you next week” check-up. As the wife and business manager of the psychiatrist profiled in the article says, “It’s all about volume.” One only hopes that most of the patients take his advice to see a therapist.

In fact, there is a growing body of evidence favoring psychotherapy over medications in mental health, notably in depression. In a recent meta-analysis in the Journal of Nervous and Mental Disease comparing psychotherapy with second-generation antidepressants (SGAs), researchers found that “ [b]ona fide psychotherapy appears as effective as SGAs in the short-term treatment of depression, and likely somewhat more effective than SGAs in the longer-term management of depressive symptoms.”

And in the March issue of AJN, we report on a study published in the Archives of General Psychiatry, which found that “cognitive therapy combined with […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:13:55-05:00March 7th, 2011|Nursing|1 Comment