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 […]

2016-11-21T13:01:33-05:00January 15th, 2016|Ethics, Nursing, nursing perspective, pain management, patient engagement, Patients|2 Comments
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Watching a Friend Fade Away: A Nurse’s Account of the Progress of Dementia

Illustration by Eric Collins, ecol-art.com. All rights reserved. Illustration by Eric Collins, ecol-art.com. All rights reserved.

By Jacob Molyneux, senior editor

Alzheimer’s disease and dementia have been in the news. There have been major movies about what’s it’s like to suffer the gradual loss of the ability to understand and to negotiate the world around us, with leading roles played by stars like Julianne Moore. The challenges of caregiving are receiving increasing attention, as are the growing pressures on our medical system. Every month there’s a report of a new potential cure, or a potential cause, or ways we might be able to fend off the illness through exercise, mental calisthenics, diet, and medications.

The January Reflections essay, written by Deborah Lane, a critical care nurse and community volunteer in St. Augustine, Florida, is called “Watching a Friend Fade Away.” Here’s the opening paragraph:

Frankie was a fast wit, a ginger-headed joker, impeccably dressed, and the first to laugh. She was a master’s-educated teacher who developed programs for at-risk teens, teaching pregnant high school students skills for employment and effective childcare. She loved to cook and her home was warm with beautiful arts and crafts she had made. She was a wonderful friend. Disease changed it all.

The author brings the perspective of both a loving friend and a nurse to this short, beautifully told account of the changes in her friend over the years, the efforts of two couples to keep spending […]

2016-11-21T13:01:38-05:00December 29th, 2015|narratives, nursing perspective, patient engagement|0 Comments
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How a Nurse Quietly Helped One Intern Out of a Tricky Situation

Illustration by Annelisa Ochoa. All rights reserved Illustration by Annelisa Ochoa. All rights reserved

In this month’s Reflections essay, “My Turn,” a recently retired physician tells a story of how a nurse adroitly helped him through a very disorienting moment when he was still an intern. Here’s a bit of the setup:

Medicine was my first rotation as an intern. . . . [T]he medicine rotation had a particularly intimidating reputation and a red-hot I was not. I was terrified.

On morning rounds every day our entourage of physicians, nurses, and students would go room to room discussing each patient. I can still see the open door to Mrs. Finkelstein’s room near the morning sunlight at the end of the hallway. Mrs. Finkelstein was old and was dying. And every morning when we walked in, her husband was sitting there next to the bed, holding her hand. He told us regularly how many years they had been together. We each dreaded being the one on call when she died.

There are many situations in medicine and nursing that require a certain amount of experience—most readers will agree that this is definitely one of them. At a certain point in the story, the author finds himself being asked a question that absolutely needs to be answered, and answered immediately. It’s not […]

2016-11-21T13:01:41-05:00December 9th, 2015|career, narratives, Nursing, nursing perspective, patient engagement, Patients|0 Comments
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Attention to Patients’ Mobility: Low-Tech But Essential

A critical care nurse led a multidisciplinary team to explore the effects of a dedicated ‘mobility team’ on functional and other outcomes in ICU patients.

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

julie kertesz/ via flickr creative common julie kertesz/ via flickr creative common

It’s long been known that immobility leads to deconditioning. Various studies indicate that muscle strength drops by 3% to 11% with each day of bed rest. As most of us have witnessed firsthand in both patients and family members, it can take months to regain pre–bed rest levels of functioning. For some people, the strength and mobility needed for independence never return.

In this month’s issue, a community hospital critical care nurse led a multidisciplinary team to explore the effects of a dedicated “mobility team” on functional and other outcomes in ICU patients. In “Implementation of an Early Mobility Program in an ICU,” Danielle Fraser and colleagues share what they learned.

The mobility team consisted of a physical therapist, a critical care RN, and an ICU rehab aide. Respiratory therapists worked closely with the team. Patients assigned to the early mobility intervention could progress through four successive levels of movement, from passive range-of-motion exercises to full ambulation.

Compared with ICU patients who received routine care, the patients in the intervention group were more functionally independent at discharge. In addition, this […]

2016-11-21T13:01:41-05:00December 7th, 2015|Nursing, nursing perspective, nursing research, patient engagement|0 Comments
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Thanksgiving in the ICU: Woven into the Tapestry of Traditions

By Marcy Phipps, BSN, RN, CCRN. Editor’s note: This post, originally published in 2011, remains as timely as ever. The author is now chief flight nurse at Global Jetcare.) 

cranberries

I’ll be working this Thanksgiving. I’ve worked so many Thanksgivings that the ICU feels woven into the tapestry of my own traditions. I don’t really mind; the cafeteria serves a fitting feast that’s embellished by the homemade treats we bring in, and although we won’t actually be watching it, the Macy’s parade will be on. Somehow, the smells and sounds I associate with the holiday will mix and mingle with the usual bustle of critical care, and it’ll feel like Thanksgiving. It’s actually a nice day to be at the hospital—for the nurses, that is.

For our patients and their families, I know hospital holidays fall far short. We have one patient, in particular, who’s been with us for a while. Her husband’s been a fixture at her side throughout her stay, and I expect to find him stationed there this Thanksgiving. Hospital turkey and television won’t give him the comfort or peace that he seeks, and I don’t know that he’ll be giving thanks. For many weeks I’ve watched him skirt a fine line between gratitude and despair; things could always be worse, but they could certainly be better.

When I stop to count my blessings, I’m overwhelmed. I belong to a profession that I’m passionate about—one that brings me great […]

2016-11-21T13:01:43-05:00November 25th, 2015|career, narratives, nursing perspective, patient engagement|2 Comments
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