Serious Mental Health Issues: No Room for System Errors

I knew that my patients were once without mental illness, just like my little sister Doris had been before her diagnosis 10 years before, and I always tried to picture them like that, each their own best version of themselves.

A sister’s preventable death.

In this month’s Reflections column, “No Room for Error: Reflections on My Sister,” family nurse practitioner Kelly Vaez shares the story of the unexpected death of her sister, who had been diagnosed with schizophrenia ten years earlier. It’s particularly heart-wrenching to be able to see clearly, in retrospect, the ways in which our rushed, fragmented, and mental-health-unfriendly health care system contributed to what was probably an easily preventable death.

A dentist prescribed an unusually long course of antibiotics after a routine tooth extraction. The primary care team seemed unaware of the antibiotic therapy. No one made the connection between Doris’ diarrhea and this antibiotic, a frequent cause of C.diff infection.

And finally, loperamide—a drug that should never, ever be given for diarrhea that might be caused by C. diff—was prescribed with what seems to have been minimal assessment for the cause of the diarrhea. Was this last because the patient was a young adult with schizophrenia, […]

2020-02-10T10:13:29-05:00February 10th, 2020|mental illness, Nursing|1 Comment
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Recent Data on Physical Inactivity Points to a More Active Role for Nurses

“. . .more attention should be given to considering total daily sitting time and to understanding the individual, social, occupational, and community environments that contribute to [it]. Nurses have a pivotal role to play in increasing public awareness about the potential adverse effects of high-volume and prolonged uninterrupted sitting.” –“Too Much Sitting: A Newly Recognized Health Risk”

“Often when I ask patients about their lifestyle, they are quick to admit they need more exercise. As a nurse, I view such conversations as opportunities to discuss and encourage physical activity.” –“The Evolution of Physical Activity Promotion”

According to recently released data from the Centers for Disease Control and Prevention (CDC), more than 15% of U.S. adults say they don’t engage in any physical activity.

Health effects of being physically inactive.

Leading a sedentary lifestyle can lead to well-documented detrimental health effects, including an increased risk of developing cardiovascular disease, type 2 diabetes, and certain types of cancer. The World Health Organization estimates that insufficient physical activity results in 3.2 million deaths annually.

Sedentary behavior varies based on location and race/ethnicity.

Using data collected from 2015 to 2018 as part of the Behavioral Risk Factor Surveillance System, the CDC notes that inactivity levels range from an estimated 17.3%  to 47.7%, depending on […]

2020-02-05T10:52:46-05:00February 5th, 2020|exercise, Nursing, personal health practices, Public health|0 Comments
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As Another Coronavirus Begins to Spread, Follow Reasonable Precautions and Avoid Fear-Mongering

(Editor’s note: Published January 24. The situation has considerably changed in the intervening weeks, during which the virus has rapidly spread across the globe. We obviously now know a great deal more about the dangers it presents.)

Emerging infections are part of our world—more evident these days because we have the tools and global communication networks to quickly identify them. This month, we’ve begun another crash course in the initial management of a new pathogen.

Short timeline from first cases to screening test availability.

Rumors of a concerning cluster of undiagnosed pneumonia in Wuhan, China, surfaced on social media on December 31. The patients weren’t responding to antibiotic therapy, but tests were negative for the usual viral suspects. World Health Organization staff quickly connected with Chinese health officials and testing and epidemiological investigations kicked into high gear.

Many of the infected patients had worked at a fish and live animal market in Wuhan, suggesting that the illnesses might be zoonotic (passing from animals to human) in origin. On January 7, the pathogen was identified as a new coronavirus, related (though not closely) to the coronaviruses that cause SARS and MERS. The viral genome was quickly sequenced, and on January 12, China shared the genetic sequence with the global scientific community. By […]

2020-03-19T17:12:45-04:00January 24th, 2020|infection control, infectious diseases, Nursing, Public health|1 Comment
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Looking Back to Look Forward: Top Health, Nursing, Policy, and Clinical Practice News of 2019

Photo via Flickr / Luis Marina

Each January, AJN takes a close look at the most noteworthy health care–related news of the past year, from general health stories and policy to specific nursing and clinical issues. Which stories stood out in 2019? Here’s a rundown:

Health care news

  • Negative trends intensify for key measures of population health and access to care. As life expectancy declines again in the United States, signaling a three-year trend, the Affordable Care Act remains under threat from GOP-sponsored litigation; children have been losing coverage; new work requirements and paperwork barriers are undercutting Medicaid coverage gains; and rising drug costs are in the spotlight.
  • Cyberattacks and hospital data security. Health care organizations’ cybersecurity spending lags behind that of other industries.
  • A changing climate. As environmental protections are weakened or rolled back, new research details the significant and long-lasting health consequences of climate change.
  • Women’s reproductive health. The U.S. maternal mortality rate continues to rise, and several states have passed legislation to curtail abortion access.
  • Society in distress. In 2019, Americans experienced the public health consequences of political discord, poverty, and unaddressed social needs, as magnified by the crisis at the border and rising rates of gun violence and homelessness.

2020-01-14T09:16:17-05:00January 14th, 2020|health care policy, Nursing|0 Comments
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2020: The International Year of the Nurse and Midwife

By Barbara Stilwell, PhD, RN, FRCN, executive director, Nursing Now, a three-year global campaign seeking to raise the profile of nurses

Barbara Stilwell of Nursing Now

The World Health Organization has declared that 2020, the 200th anniversary of Florence Nightingale’s birth, will be the International Year of the Nurse and the Midwife. The year represents a once-in-a-generation opportunity to celebrate and thank nurses and midwives for all that they do, and to make clear the critical contribution that our professions can make in achieving universal health coverage. It is urgent that we make the most of 2020.

A global health care workforce crisis.

We are edging ever closer to a significant global health care workforce crisis. The WHO estimates that we are facing a shortfall of 18 million health workers to achieve and sustain universal health coverage by 2030—and approximately half of that shortfall, 9 million health workers, are nurses and midwives.

It is high time, therefore, that countries think radically differently about the way they train, deploy, and look after their health workers, particularly nurses and midwives. This will require political commitment and domestic resource mobilization. Countries will need to increase their allocation to health budgets to invest in their nursing and midwifery […]

2020-01-03T10:39:51-05:00January 3rd, 2020|health care policy, Nursing, nursing perspective, Public health|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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