Medical Marijuana: A Nurse’s Primer

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

Illustration by J Paradisi. Illustration by J Paradisi.

Since I wrote “Marijuana Legalization and Potential Workplace Pitfalls for Nurses Who Partake” in July 2014, a few things have changed. For one, Measure 91 passed in Oregon, making it the third state to legalize recreational marijuana. Medical marijuana, however, has been legal since 1998 in Oregon, currently one of 23 states nationwide.

Also, when I wrote the earlier post, I was an infusion nurse—now, as an oncology nurse navigator, I’m asked about medical marijuana often, and I need to know the answers, as do all nurses practicing in states with legalized medical marijuana. Nurses working in oncology, emergency departments, pain management, infusion clinics, and pediatrics have high exposure to patients with medical marijuana cards.

By ‘knowledge,’ I don’t mean knowing everything, but knowing where to find what you need to know. In Oregon, for example, information about medical marijuana is found at the Oregon Medical Marijuana Program (OMMP). The Web site includes qualifying diagnoses, a downloadable handbook, an application packet with instructions, and a list of approved dispensaries. While retail issues surrounding recreational marijuana are still being sorted out, medical dispensaries in Oregon sell recreational marijuana to clients aged 21 and older.

Patients using medical marijuana are […]

2016-11-21T13:01:50-05:00October 27th, 2015|nursing perspective, Patients|0 Comments
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Violence Against Women: Old Stories Repeat, But Some Progress

By Maureen Shawn Kennedy, AJN editor-in-chief

Emergency lights #5, by DrStarbuck via Flickr Emergency lights #5, by DrStarbuck via Flickr

It seemed ironic that, during this month of domestic violence awareness, a Florida judge showed little awareness of the fear that intimate partner violence can instill. Judge Jerri Collins came under attack from victim advocacy groups after she jailed a young mother who was a victim of domestic violence for failing to show up in court to press charges against her husband. According to various news reports, the distraught woman was afraid to face her husband in court for his sentencing to 16 days for choking and threatening her with a knife. Advocates say the judge’s action sends a message that may result in many women not bringing charges against abusers.

According to the CDC report Intimate Partner Violence Surveillance: Uniform Definitions And Recommended Data Elements (version 2.0; 2015), “over 1 in 5 women (22.3%) and nearly 1 in 7 men (14.0%) have experienced severe physical violence by an intimate partner at some point in their lifetime.” The real numbers are almost certainly higher, as many victims are afraid to report their partners for fear of retaliation once the abuser is released from jail. There are too many […]

2016-11-21T13:01:51-05:00October 19th, 2015|Nursing, nursing perspective, Patients|0 Comments
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Case Studies in Effective Care Coordination by Nurses in Rural Kansas

“I did not have a clue how to proceed.”

Care coordinator Burlay Parks meets with a patient at Greeley County Health Services in Tribune, Kansas. Photo by Chrysanne Grund. Care coordinator Burlay Parks meets with a patient at Greeley County Health Services in Tribune, Kansas. Photo by Chrysanne Grund.

The opening sentence of “Pathfinding on the Frontier,” the In the Community column in the October issue of AJN, alludes to the confusion even the most organized and savvy person sometimes feels when navigating our health care system.

In rural settings, referrals to specialists from primary care providers can be difficult for patients and families to follow up on, sometimes requiring that patients travel great distances.

Patient care coordination has been shown to decrease the number of ED visits and hospitalizations. The authors of this article explore care coordination in two Kansas counties, presenting three case studies showing how a nurse care coordinator—as part of a program at a rural primary care practice funded by a two-year grant from the Robert Wood Johnson Foundation—resolved complex issues for seriously or chronically ill patients involving medications, specialists, and diagnoses. […]

2016-11-21T13:01:56-05:00October 12th, 2015|Nursing, nursing perspective, Patients|1 Comment
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The Afterlife of Trauma, Near and Far

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

Mixed media illustration by Julianna Paradisi Mixed media illustration by Julianna Paradisi

The alarm clock rang noisily. I wasn’t ready to surrender the cozy cocoon of my bed and venture into the emotional turbulence of this particular day: The 14th anniversary of 9/11.

The week leading up to it was rough. My stepfather had quadruple coronary bypass surgery in another city. Although it was successful, and his children were there to help and support my mother, I’ve felt guilty for not being there myself, because I’m the nurse in the family, and I feel responsible for every medical problem that arises for the ones I love—even if I’m not really needed.

Besides this, at work we’re in one of those cycles where every patient gets bad news: The cancer has invaded the borders of another organ, or the patient is incredibly young for the diagnosis that’s been received. Six months into my career as an oncology nurse navigator, I realize the emotional toll from secondary trauma is often more related to a previous job as a pediatric intensive care nurse than that of my more recent position as an oncology infusion nurse.

Because of all this, I decided to minimize my media exposure to the trauma of 9/11 this year. I stayed off of Facebook, and instead of watching the morning news I listened to Lyle Lovett croon the delightfully […]

2016-11-21T13:01:58-05:00September 28th, 2015|career, narratives, Nursing, nursing perspective, Patients|2 Comments
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Unexplained Deathbed Phenomena: Honoring Patient and Family Experience

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

by luke andrew scowen/flickr creative commons luke andrew scowen/flickr creative commons

When my dad died, a special little travel clock that he’d given me years before stopped working. It restarted a week after his death, and continued running for years. I have no explanation for this sudden lapse in timekeeping, but it made me feel closer to my dad.

I’ve heard many other stories of unusual events surrounding the death of a loved one. I was therefore delighted to read this month’s Viewpoint column, “Letting Patients and Families Interpret Deathbed Phenomena for Themselves.” In this short essay, Scott Janssen presents some intriguing research findings and a compassionate argument for speaking openly about these occurrences. He writes:

“It’s an open secret among those of us working with the dying – there’s a lot of strange stuff going on for patients, as well as for the clinicians and family members who care for them, that rarely if ever gets talked about: near-death experiences, synchronistic coincidences (stopped clocks at time of death, for example), out-of-body experiences, and visitations from deceased loved ones.”

Janssen, a former hospice social worker and now a psychotherapist, sees such phenomena as part of “the normal continuum of experiences at the end of life.” He calls upon clinicians to create safe contexts in which patients and families can share these experiences without fear that they will be judged, ridiculed, or dismissed by caregivers.

It’s food for […]

2016-11-21T13:01:59-05:00September 21st, 2015|Nursing, nursing perspective, patient experience, Patients|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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