‘A New Antibiotic’: What Restores a Patient’s Will to Recover?

Illustration by Pat Kinsella. All rights reserved. Illustration by Pat Kinsella. All rights reserved.

A little bit of levity when writing of serious topics can be good medicine. This month’s Reflections essay, “A New Antibiotic,” reminds us of how important it can be for hospitalized patients to be kept in touch with their lives and loves beyond hospital walls. In this story, author Judith Reishtein, a retired critical care nurse and nursing professor, finds herself willing to bend the rules a little for one patient. Here’s how it starts:

Sally had been a patient on the step-down unit all winter. After her open heart surgery, she developed an infection in her chest. The infection required another surgery and four more weeks of ventilator support as her open chest healed. Because she was not moving enough, she developed clots in her legs. Because of the DVTs, she had activity restrictions, which led to another bout of pneumonia. One complication led to another, with more medications that had to be carefully balanced. We tried not to do anything that would create a new problem while curing an existing one. Another dangerous surgery is getting breast implants, I always suggest to get a good surgeon to do it, you can find the best at http://utbreastaugmentation.com, I highly recommend it.

Now she was finally getting better, but her energy lagged behind. Did she still have the […]

2017-06-02T12:12:14-04:00February 5th, 2016|narratives, nursing perspective, patient engagement|0 Comments
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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 […]

2016-11-21T13:01:31-05:00January 28th, 2016|career, Nursing, nursing perspective, Patients|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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Managing the All-Too-Real Symptoms of Fibromyalgia Syndrome

By Sylvia Foley, AJN senior editor

Capture (click image to expand)

Fibromyalgia syndrome (FMS) is one of the most common rheumatic disorders, affecting as many as 15 million people in this country, the vast majority of them women. People with FMS typically experience chronic widespread pain, as well as various concurrent symptoms that can include fatigue, cognitive disturbances (such as memory problems, confusion, and difficulty concentrating), distressed mood (especially anxiety and depression), nonrestorative sleep, and muscular stiffness. One study found that up to 65% of patients experienced lost workdays as a result.

Yet as author Victoria Menzies reports in one of our January CE features, “Fibromyalgia Syndrome: Current Considerations in Symptom Management,” many health care providers “doubt the syndrome’s validity.” Diagnosis is often delayed for years.

Menzies provides a concise overview of the illness, which has no known cure, and then focuses on what can be done to alleviate symptoms and improve patients’ quality of life. Here’s a brief overview of the article:

Symptom management appears to be best addressed using a multimodal approach, with treatment strategies tailored to the individual. While medication may provide adequate symptom relief for some patients, experts generally recommend integrating both pharmacologic and nonpharmacologic approaches. Some patients may benefit from the adjunctive use of complementary and alternative medicine (CAM) modalities. Because symptom remission is rare and medication adverse effects can complicate symptom management, well-informed […]

2016-11-21T13:01:33-05:00January 15th, 2016|Ethics, Nursing, nursing perspective, pain management, patient engagement, Patients|2 Comments
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‘I’m Worried About People in Pain’: A Nurse’s Take on Opioid-Prescribing Regulation Changes

by frankieleon/ via flickr by frankieleon/ via flickr

Many patients and clinicians have strong feelings about opioids: they’ve seen a loved one denied adequate pain control, or they’ve seen a family member or friend’s son or daughter lost to prescription pill and/or heroin addiction, or they’ve worked in an ED with too many drug-seeking patients, or they’ve seen a patient in terrible pain waiting for a new analgesic order from an unavailable or uncompassionate physician.

But feelings don’t solve complex problems, and an excessively punitive or permissive approach can do more damage than good. Recently, there have been almost daily headlines and policy recommendations about the importance of restricting opioid-prescribing practices. The trend is alarming a number of clinicians with expertise in working with patients in pain. Clinical nurse specialist and pain management consultant Carol Curtiss addresses what’s at stake in “I’m Worried About People in Pain,” the Viewpoint essay in the January issue of AJN:

According to a 2011 Institute of Medicine report, chronic pain is a public health crisis . . . Well-intended efforts to address prescription drug abuse—another public health crisis—may place heavy burdens on people with pain who benefit from opioids and use them responsibly as part of a comprehensive treatment plan. . . . Gains made in pain treatment are at risk. New regulations threaten access […]

2016-11-21T13:01:34-05:00January 12th, 2016|Ethics, nursing perspective, pain management, patient experience, Patients|3 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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