Morgellons: Whatever the Cause, the Suffering Is Real

Image, magnified 60 times, depicts fiber-embedded skin removed from a facial lesion of a 3-year-old boy who the Morgellons Research Foundation says has Morgellons. Image, provided by Morgellons Research Foundation to AJN in 2008, described as depicting fiber-embedded skin removed from facial lesion of 3-year-old boy with Morgellons (magnified 60x).

By Jacob Molyneux, senior editor

As you may have read, Joni Mitchell was recently found unconscious in her home and is now in the hospital. She has attributed her health issues to a syndrome called Morgellons—a condition in which sufferers experience what they describe as fibers emerging from their skin, along with intense itching, sores that won’t heal, and a host of nonspecific symptoms such as fatigue and concentration problems.

Whether it’s a clinically verifiable illness or, as some have argued, a manifestation of a psychological condition known as “delusional parasitosis,” Morgellons is plenty real to those who experience it.

We covered this controversial illness several years back in an article called “AKA ‘Morgellons.’” I interviewed two nurses and several others about their experiences. One of the nurses (see this sidebar) was convinced she had caught the condition from a patient. I also spoke with Michele Pearson, MD, the lead investigator of a then-pending […]

2016-11-21T13:02:44-05:00April 2nd, 2015|Nursing, nursing perspective, patient engagement, Patients|1 Comment
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Two Sons, Similar injuries—Two Very Different Experiences of Pain

Vincent-2015-AJN_The_American_Journal_of_NursingWe are often amazed by the richness of the archives here at AJN. In the April issue, we reprint an essay originally published in the February 2002 issue. “Morphine. Now.” by Peggy Vincent, touches on topics as relevant today as ever: inadequate pain relief and the costs to patients of certain nursing scope-of-practice limitations.

It’s also a story, written by a nurse, of encountering very different attitudes to human suffering in two different health care institutions after injuries sustained by her own children. There may or may not be clinical details or matters of protocol that don’t accord with every reader’s current clinical experiences, but the human interactions are as familiar as ever. Here’s a brief excerpt: […]

2016-11-21T13:02:45-05:00April 1st, 2015|Nursing, nursing perspective, Patients|0 Comments
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Interprofessional Collaboration and Education: Making an Ideal a Reality

Photo courtesty of Penn Medicine. Photo courtesty of Penn Medicine.

We hear a lot about interprofessional collaboration, the potentially dynamic and enlightening process of sharing knowledge across disciplines to improve patient care, but what’s being done to make this a reality?

The promotion of interprofessional collaboration is one focus of an ongoing national initiative by the Future of Nursing: Campaign for Action, as described in “Interprofessional Collaboration and Education,” an article in the March issue of AJN.

To close the gap between policy bullet points and the reality of daily work for nurses is neither impossible nor inevitable; it depends on smaller coalitions and the engagement of multiple organizations—but also, one imagines, a willingness to engage in inquiry and to try new and imperfect processes at the local level that may need refinement over time. The article is free, but here are a couple of paragraphs that give an a good overview of why it matters and where we are:

Interprofessional collaboration is based on the premise that when providers and patients communicate and consider each other’s unique perspective, they can better address the multiple factors that influence the health of individuals, families, and communities. No one provider can do all of this alone.

However, shifting the culture of health care away from the “silo” system, in which […]

2016-11-21T13:02:49-05:00March 25th, 2015|career, Nursing, nursing perspective, Patients|0 Comments
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Missed Empathy, Missed Care: Is It Time to ‘Reconceptualize Efficiency’?

A physician’s lament is nursing’s, too.

By Maureen Shawn Kennedy, AJN editor-in-chief

By Alan Cleaver/via Flickr By Alan Cleaver/via Flickr

Last week, the New York Times Well blog published “The Importance of Sitting With Patients” by Dhruv Khullar, a Harvard medical resident. Khullar expressed regret over not spending more time with a patient who was near death, and then discussed how little time residents actually spend with patients—eight minutes, according to a Journal of General Internal Medicine study (2013) that analyzed the time of 29 interns over a month. (The study found that only 12% of the residents’ time was spent on direct patient care; 40% of their time was spent on computers.)

Khullar detailed the various activities that take him away from direct patient contact and noted as well that the shorter working hours mandated for residents had the unintended consequence of reducing time with patients. He wondered:

By squeezing the same clinical and administrative work into fewer hours, do we inadvertently encourage completion of activities essential in the operational sense at the expense of activities essential in the human sense?

The second part of the question seemed especially pertinent for nurses. Hospital nurses have long lamented that paperwork, insufficient staffing, and nonnursing tasks keep them from the bedside. The promise of computers to […]

2016-11-21T13:02:50-05:00March 23rd, 2015|career, Nursing, nursing perspective, Patients|5 Comments
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Early Localized Prostate Cancer: Nurses Can Help Men Weigh Diagnostic, Treatment Options

By Jacob Molyneux, AJN senior editor

A new diagnosis of prostate cancer can be daunting. Nurses play an increasingly important role in helping men and their partners find their way through the maze of available information and choices. One of the two March CE feature articles in AJN, “Early Localized Prostate Cancer,” gives a thorough overview of tests and treatments.

The author, Anne Katz, is a certified sexuality counselor at CancerCare Manitoba, a clinical nurse specialist at the Manitoba Prostate Centre, and a faculty member in the College of Nursing at the University of Manitoba, Winnipeg, Canada, and Athabasca University, Alberta, Canada. She is also the editor of Oncology Nursing Forum. Writes Katz:

. . . as many as 233,000 men in the United States are diagnosed with prostate cancer each year, 60% of whom are ages 65 or older. Most diagnoses are low grade and localized . . . . Since low-grade, localized prostate cancer is slow growing and rarely lethal, even in the absence of intervention, it can be difficult for men to make treatment decisions after diagnosis—particularly if they do not understand the nuanced pathology results they receive and the potential for treatment to result in long-term adverse effects that can profoundly affect quality of life.

Pros_Cons_PSA_ScreeningThe article discusses options for intervention, potential adverse effects associated with each option, and, crucially, the nurse’s “role in helping men and their […]

2016-11-21T13:02:51-05:00March 18th, 2015|Nursing, nursing perspective, patient engagement, 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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