Identifying and Addressing the Profound Mental Health Effects of Climate Change

Residents amid homes consumed by flood and fire, White Sulphur Springs, WV, June 2016. Photo © AP Photo / Steve Helber.

A new word for an era of increasing environmental instability.

A lot of attention is currently paid to the physical impacts of climate change, including extreme heat events, droughts, extreme storms, and rising sea levels. Far less attention has been paid to the psychological impacts of this change. For example, you may not be familiar with the term “sostalgia.” It’s related to the older word “nostalgia,” but was created to reflect the environmental and often related sociopolitical uncertainty of our current times—that is, of change that’s slow and incremental, and often even denied, and then sometimes rapid and catastrophic and impossible to ignore.

The term is explained in more detail in an April feature article in AJN, “Climate Change and Mental Health,” by Janna Trombley, Stephanie Chalupka, and Laura Anderko:

Solastalgia is a term coined a decade ago by philosopher Glenn Albrecht . . . It refers to the psychological distress resulting from degradation of one’s home environment.49 Solastalgia can occur as a result of events that impact climate change, including drought, wildfires, and natural disasters.49, 50 When environmental degradation […]

The Limitations of Rating Nursing Care by Customer Surveys

Ink and collage on paper by Julianna Paradisi 2017

Either They Loved It or They Hated It

While toasting the same English muffin for the second time that morning and cursing that it would make me late for work, I conceded we need a new toaster. It doesn’t matter whether I set the darkness level on 1 or 4;  the muffin comes out barely tinged. Select 5 or beyond, the muffin is burnt, and sets off the smoke detector. It’s time to buy a new toaster.

I found one I liked, shopping online. It had been purchased by over 1,500 other people; 55% of them rated it 5 stars. The other 45% of ratings ranged between 1 and 4 stars. The comments, however, were evenly split, 50/50. People either loved it or hated it. There was no in-between.

This made me laugh.

As with Toasters, So with Nursing Care

Likewise, many hospitals, in an effort to improve care, send out satisfaction surveys asking patients to rate their nursing care. In my experience, the results are similar to the toaster’s ratings: about half the patients rave about their care. Some mention their nurses by name, elaborating on specific details about their experience.

The other half complain bitterly that their hospitalization. The nursing care, they say, was the worst experience of […]

A Place for Faith: Despite Chronic Illness, a Return to Bedside Nursing

flickr creative commons/by krassy can do it

Relearning the Details of Clinical Nursing

After being away from bedside nursing for over 11 years, I recently returned to this role on the same medical-surgical floor I’d worked on 11 years earlier. The impetus behind such a drastic transition was, in part, my return to nursing education as a clinical nursing instructor. As an educator, I felt the need to update my own clinical skills as I instructed young nurses eager to enter my profession.

The other reason for returning to clinical nursing had to do with a spiritual pull I felt in my heart, a hope that I’d be able to to show patients the compassion, empathy, and patience they all deserved. I’d come to realize that I’d sometimes lacked these qualities when I was a younger bedside nurse. Now I felt that God was giving me a kind of ‘do-over’—and I had to at least try to live up to this expectation.

Within the first week of orientation, I quickly realized how different things had become in the nursing world. The last time I’d worked as a clinical nurse on this very unit in 2005, the hospital was still using paper documentation, private community physicians still rounded on their patients, and there were no ‘computers on wheels’ or in patients’ rooms to access patient information […]

2017-03-08T11:17:02+00:00 March 6th, 2017|career, Nursing, patient experience|5 Comments

Dialysis Patients’ Very Different Life or Death Choices

Illustration by Barbara Hranilovich. All rights reserved. Illustration by Barbara Hranilovich. All rights reserved.

This month’s Reflections essay is called “Sitting with Death.” The subtitle provides a little context: A social worker on a dialysis unit bears witness to patients’ life or death choices. Despite the sad stories the author tells, this remembrance doesn’t leave a reader feeling disheartened.

Retired social worker Linda Converse writes that starting work at a dialysis center was at first daunting. How could she talk to patients about such an ultimate choice as whether or not to give up dialysis?

But over time she began to understand that there was usually no right answer. For each person, there was a different personal algorithm that guided the choice, one based on such factors as quality of life, obligations to loved ones, values, and much else. Writes Converse:

I’ll never forget some of the patients who chose to stop dialysis, nor will I forget those who chose to hold on for as long as possible. There was no consistent logic when it came to an individual’s choice. What one person considered an impossible quality of life, another wouldn’t.

[…]

2016-12-05T08:57:58+00:00 December 5th, 2016|patient engagement, patient experience|0 Comments

Information for Nurses on Voluntarily Stopping Eating and Drinking (VSED)

The New York Times recently published an article by Paula Span called “The VSED Exit: A Way to Speed Up Dying, Without Asking Permission.” VSED stands for voluntarily stopping eating and drinking, an end-of-life option that is, on the surface, as simple as its name suggests. Span, who recently attended the first conference devoted to VSED, gives an overview of one mother’s choice to end her life using this method. She also does an excellent job enumerating the ethical, practical, and legal implications of choosing to stop eating and drinking.

screen-shot-2014-11-05-at-4-39-13-pmWhich types of patients is such a choice appropriate for? How much suffering does it involve? Are there legal pitfalls of involvement in the VSED process by nurses and physicians? We can expect that all of these questions and more will be receiving growing attention in the coming years.

Late in the article, Span quotes Judith Schwarz, PhD, RN, now clinical coordinator of End of Life Choices New York. In 2009, AJN published a CE article, “Stopping Eating and Drinking,” by Schwarz. This substantive article centers around a detailed case study. “Gertrude,” we learn, has lived a very full life. All the things that give her pleasure and a modicum of freedom are gradually being removed as her body’s […]

2016-11-21T13:00:53+00:00 October 24th, 2016|Ethics, Nursing, patient experience|0 Comments