Baby Boxes: Gifts Intended to Educate New Parents About Safe Sleeping

A Gift for Every New N.J. Parent

When I had my first child in New Jersey more than a decade ago, the hospital sent me home with a bag of product samples, including a few diapers, a package of wipes, two cans of formula, and an assortment of coupons. These items were helpful to varying extents—I was breastfeeding and unlikely to buy the products featured on the coupons, but the wipes and diapers certainly came in handy. So did the little hat a nurse put on my son’s head soon after birth. With its horizontal pink and blue stripes, this soft beanie that actually stayed in place was ever present during his first few weeks. It was the most useful and well-loved relic of our hospital stay.

The parents of infants in New Jersey are now given an even more practical item, one that also has the potential to reduce infant mortality rates: a baby box. This laminated, nontoxic cardboard box is packed with items that are essential during the early days of parenthood—including diapers, wipes, clothing, and breast pads—but it’s also a bed. The box, which includes a mattress and sheet, provides a safe place for infants to sleep during their first year. It’s free to all new and expectant parents in the state who watch a 20-minute educational video and take a quiz online. Upon completion, they receive a certificate that allows them to pick up the box at a local distribution center or order it by mail.

February 24th, 2017|Nursing, Public health|0 Comments

An Oncology Nurse’s Perspective on the Health Insurance Situation

Money Bag/ by Julianna Paradisi/ all rights reserved

Costly Care

I was an oncology infusion nurse in a hospital-based ambulatory center for a number of years, many of them before the Affordable Care Act (ACA) was signed into law in 2010. Besides administering chemotherapy and blood products, I infused medications to patients with sickle cell anemia as well as chronic autoimmune disorders such as rheumatoid arthritis, lupus, and Crohn’s disease.

The common denominator among these diseases is the high cost of the medications used to treat them, at the time ranging from $3,000 to $10,000 per treatment. I know, because patients told me, their nurse.

I also know because uninsured patients were required to fill out paperwork declaring their lack of income, prior to receiving authorization for charitable treatment. If they were sick enough, they were admitted to the hospital for initial treatment, at more expense than outpatient infusion, until the paperwork was completed and approved.

These were particularly difficult times to be an infusion nurse.

Some patients lost their jobs during cancer treatment, because the cost of their cancer care increased their employer’s insurance coverage risk pool rates.

Other patients worked night shift before arriving, sleepless, for chemotherapy as soon as we opened in the morning. They couldn’t afford to lose their health […]

February 22nd, 2017|health care policy, Nursing, Public health|1 Comment

The Role of Prevention and Standardized Care in Improving CKD Outcomes

Slowing Chronic Kidney Disease Progression

Most nurses have worked with patients with chronic kidney disease (CKD). Their condition may have been related to diabetes, high blood pressure, an acute infection, or other assaults on the kidney. I’ve tended to see a diagnosis of CKD as the beginning of an inevitable decline. Certainly, “prevention” didn’t seem a relevant concept at this point; my role was to assess and monitor, teach and support, and hope for the best.

Fig. 1. The Nephron. Blood flows into the nephron through the glomerulus. Filtrate from the glomerulus flows into Bowman’s capsule, then through the proximal tubule, the loop of Henle, and the distal tubule, a series of tubules that modifies the filtrate primarily by reabsorbing water and needed electrolytes into the bloodstream. The modified filtrate (urine) then flows into the collecting duct and eventually drains into the renal pelvis. Courtesy of National Kidney Disease Education Program and the NIDDK.

However, the authors of the February CE feature, “Improving Outcomes for Patients with Chronic Kidney Disease,” make it clear that many of us (nurses as well as physicians) aren’t up to date about what we can do to slow the progression of CKD. As authors Norton et al. note:

“The greatest opportunities to reduce the impact of CKD […]

February 15th, 2017|Nursing, Public health|0 Comments

Culture as a Key to Health

By Beth Toner, MJ, RN, senior communications officer, Robert Wood Johnson Foundation

(Video caption: The Dakota are a horse tribe, and Charley, a retired reservation policeman, takes care of abandoned horses, connecting them to the tribe’s youth to help the young redefine themselves in relation to tribal history. Video used by permission; produced by Purple States LLC with support from the Robert Wood Johnson Foundation.)

I consider myself, and have been told by others that I am, an extraordinarily patient person—except behind the wheel of a car.

I commute 80 miles each way to work (that’s how much I love my job), so I spend a lot of time in the car. That, in turn, means I get annoyed—unreasonably so—by folks who are driving in such a way that forces me to spend a minute longer than I need to in that car. Now, it never leads to dangerous or aggressive driving, but it does lead to a lot of windows-up ranting while I’m on the road. One day, while I was in mid-rant, my 21-year-old daughter finally said, “Mom, you need to imagine other people complexly.”

I think of that conversation often as I listen to the polarizing dialogue that continues across our nation. What if, across the nation, we each imagined other people complexly, not just as their culture, their gender, their political party, their favorite television show? People, with all their joys and sorrows, their best qualities and their deepest flaws—uniquely themselves, yet with so much […]

February 1st, 2017|Nursing, Public health|1 Comment

A Public Health Nurse at the Intersection of Birth and Death

by Lisa Dietrich for AJN/ all rights reserved

The January Reflections essay in AJN is called “Touching Death, Touching Life.” The author, Yaffa Vinikoor, is a public health nurse who describes a patient she refers to as Sidney. Over time, she’s come to know the worn furniture of Sidney’s small apartment and the details of his life, such as Arnold, his paid caretaker, and Sidney’s younger wife, who lives separately. Sid has dementia and several other conditions and is in decline. “Sid,” she writes “usually lay slanted, like he’d been haphazardly dropped onto the enormous mattress, hair askew and face contorted.”

The essay explores what it’s like to be pregnant while doing such work. Vinikoor’s situation that summer puts her in relation to two very different currents:

I continued to do my work in the city as a public health nurse with the chronically ill homebound up until the day I went into labor. . . . I continued to walk miles per day, the nursing supplies in my backpack bowing my back and the baby in my belly guiding me forward . . . . As I cared for those whose lives were in steady decline, I thought about what giving birth to new life would be like.

[…]

January 27th, 2017|Nursing, nursing stories, Public health|2 Comments