A Matter of Public Health: Physicians Make Case for Vaccinating Immigrants in Custody

For three days last week, physicians from around the country led demonstrations and a vigil outside of Customs Patrol and Border Protection (CBP) facilities in the San Diego area. After receiving no response to their repeated offers to the departments of Health and Human Services and Homeland Security to provide free flu vaccinations to immigrants in custody, the physicians (and a few NPs) had come to the border with donated influenza vaccine to press for a pilot vaccination program. CBP officials finally said they would pass the request up their chain of command.

Preventable deaths, plus a matter of the larger public health.

Three migrant children died in CBP detention centers during last year’s flu season. The last hours of 16-year-old Carlos Gregorio Hernandez Vasquez, who died in May of influenza, were documented on a grim surveillance camera video that recently circulated widely on the Internet. But the issue of influenza vaccination for migrants is not “merely” one of such preventable deaths; it is a  public health issue. This year’s flu season has ramped up in recent weeks, and a “window of opportunity” for vaccinating this vulnerable population is closing.

The CDC recommends that everyone six months of age and older receive influenza vaccination each year. […]

2019-12-19T14:10:39-05:00December 19th, 2019|infectious diseases, Nursing, Public health|1 Comment
Read More

A Nursing Way with Meaning

“I have found that the residents of Johnson Tower teach me more about being a nurse and a human being than you would imagine.”

Despite our seriously malfunctioning health care system, sometimes we are lucky enough to be reminded of the richness of our practice. Most of us experience a bright spot or two on most days—a patient’s condition finally improves, and we know we had a hand in that; we are able to spend some “quality time” to help a patient cope with her illness; a discharged patient returns for a happy visit.

Thriving, not just surviving.

A few of us, though, are lucky enough to have nursing work in which we can thrive, and not merely survive, every day. In this month’s Reflections column, “The Way of Johnson Tower,” nurse practitioner Mark Darby describes his work in an unlikely setting: a medical clinic located in a public housing high-rise. Resources may leave something to be desired—occasional leaks from the laundry above seem to target the clinic’s centrifuge—but his practice is rich and fulfilling.

“All these people, despite their circumstances, teach me more about generosity, perseverance, and hope than I could learn anywhere else.”

[…]

2019-12-02T12:57:58-05:00December 2nd, 2019|Nursing, nursing roles, nursing stories, Public health|1 Comment
Read More

Former Pediatric ICU Nurse: Where Are the Smart Guns?

Stars for the dead.

On the afternoon of Thursday, November 14, 2019, I visited our local art museum to see a retrospective exhibit by a conceptual artist. Walking into the museum gallery, the first piece you encounter is an installation of several dark blue banners suspended from the ceiling. On their blue fields are embroidered white stars; lots of white stars, 14,718 in all. Each star represents a person killed in the United States by another person with a gun in 2018.

It’s a sobering statistic, but what caught my attention was the half-dozen high school students seated cross-legged on the museum floor inside the circle created by the hanging banners. They faced each other silently. None of them was texting or taking selfies, which was remarkable in itself.

I hadn’t yet heard that earlier in the day two high school students died, and several more were injured in another school shooting, this one at Saugus High School in Santa Clarita, California. Later the shooter, a student, died of self-inflicted gunshot wounds.

As seen in the pediatric ICU.

As a former pediatric intensive care nurse, I have personally cared for several child gunshot victims. They were nice children from nice families who happened to have loaded guns in their homes.

Forgive my frustration, […]

2019-11-20T10:13:03-05:00November 20th, 2019|Nursing, Public health|1 Comment
Read More

Informing Policy, Driving Change: No Longer Optional for Nurses

Nurses have the knowledge, skills, and obligation.

Rep. Lauren Underwood, left, with AAN president Karen Cox

The American Academy of Nursing (AAN) kicked off its annual policy conference last week by honoring Rep. Eddie Bernice Johnson, (D-TX), the first registered nurse elected to Congress, and hearing from the nurse most recently elected to the House, Rep. Lauren Underwood, (D-IL). Their presence underscored a viewpoint that is gaining traction in prominent circles, from the World Health Organization to the National Academy of Medicine: Nurses have the knowledge, skills, and obligation to inform policy and drive change.

During her talk, Underwood laid out her policy priorities and expressed her fervent belief that for nurses, “engaging in policy is not optional.”

Underwood serves on three House committees—Veterans’ Affairs, Homeland Security, and Education and Labor—and within those on subcommittees dealing with emergency preparedness, disability assistance, and other topics where she uses her health expertise to influence policy on a range of issues. These include gun violence prevention, black maternal health, infant mortality, drug pricing, and suicide among veterans.

A data-driven approach.

Underwood’s approach to policymaking is data driven. Prompted by research on medication adherence, she sponsored a bill to allow veterans to receive a full-year’s supply of contraceptives rather than having to refill their prescriptions every three months.

When asked […]

2019-10-29T15:50:34-04:00October 29th, 2019|Nursing, nursing perspective, nursing roles, Public health|0 Comments
Read More

Revising Protocols in the Midst of Disaster Response

Refining an unsuccessful triage process.

Health care moves at such a rapid pace these days that quality improvement (QI) seems to be never-ending. We know these projects can help us to better our care, but it sure does become tiring when yet another new protocol or data responsibility falls on our shoulders. What if you were tasked with an urgent QI project in the midst of responding to a disaster?

Considering our own repeated scrambles to squeeze QI into ordinary workdays, imagine what it would be like to manage QI in a setting of extremely limited resources, where many people were desperate for emergency services—and you had to “get it right,” ASAP.

In “Implementing a Fast-Track Team Triage Approach in Response to Hurricane Maria” (free until November 15), Brittany Parak and colleagues describe their efforts to improve emergency services after their mobile military hospital was deployed to Puerto Rico, just 16 days after Hurricane Maria devastated the island.

“We soon discovered it would be necessary to refine our triage process, as our initial strategy resulted in limited access to care, prolonged wait times, many people leaving without being seen, and patients with acute problems not being cared for in a timely manner.”

2019-10-24T10:04:30-04:00October 24th, 2019|Nursing, Public health|0 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top