What Nurses Need to Know About Antidepressant Medications

Rising rates of major depression and suicide.

A recently published Health of America report from Blue Cross Blue Shield, Major Depression: The Impact on Overall Health, highlights a dramatic rise in major depression diagnoses—up 33%—from 2013 to 2016. According to the report, women were found to have major depression at twice the rate of men.

Perhaps most startlingly, rates of major depression have risen 47% among millennials, while among adolescents the increase has been 47% in boys and 65% in girls.

‘Sorrowing Old Man,’ by Vincent Van Gogh. Photo by Peter Horree/Alamy Stock Photo.

In an equally disturbing trend, the CDC has noted that the rate of suicide in the United States rose more than 25% from 1999 to 2016, with 45,000 people dying by suicide in 2016 alone. Suicide rates are higher among people who have mental illnesses, and suicide is of particular concern among those who have depression. Yet the CDC also points out that more than half of people who died by suicide had not been diagnosed with a mental health condition.

An antidepressants primer for nurses.

Given the rapidly rising rates of depression diagnoses, nurses are increasingly likely to encounter […]

2018-09-14T10:19:30-04:00September 14th, 2018|mental illness, Nursing|0 Comments
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Have A Seat—Or Maybe Not

Too much sitting is harmful.

Photo © blue jean images.

In this month’s AJN, author Linda Eanes sounds the alarm about the health risks associated with the way most of us spend much of our waking life: sitting down. Her article, “Too Much Sitting: A Newly Recognized Health Risk,” reviews research on the health effects of prolonged uninterrupted sitting (sitting for 30 minutes or more) and high-volume sitting (sitting for seven hours or more each day).

Studies show an association between high-volume and prolonged uninterrupted sitting and health risks, including cardiovascular disease, diabetes, and all-cause mortality. Sedentary time is also linked to obesity and an increased risk of certain cancers, including ovarian, endometrial, and colon cancer.

Eanes notes:

“Simply put, too much sitting, with its characteristic reduced energy expenditure and absence of whole body movement, may jeopardize health even in the presence of regular exercise.”

Exercise matters, but we’re still sitting too much.

Unfortunately, Eanes’s statement describes my life (see my September editorial) and that of most people I know: sitting at a desk, sitting while commuting, and doing some exercise a few hours a week. (Or what we like to think of […]

2018-09-10T10:06:16-04:00September 6th, 2018|Public health|0 Comments
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What Are We Breathing In?

Photo © Shutterstock.

For people who haven’t given much thought to “particulate matter” as a health hazard, the wildfires in the western United States remind us of how ambient smoke affects quality of life. Even communities not devastated by the fires—and often hundreds of miles away from them—have seen and experienced the effects of the smoke from these fires.

In this month’s AJN, authors Jessica Castner and Barbara Polivka explore particulate matter exposure and its effects on health in their article “Nursing Practice and Particulate Matter Exposure” (free until September 18). Using a detailed case history as an example, the authors offer guidance on nursing assessment and interventions to address particulate matter exposures. They also remind us how easy it is to encounter these pollutants.

“Common outdoor sources of particulate matter include industrial and traffic emissions, power plant emissions, wildfires, and wood stoves. Indoor sources include smoking, wood fires, cooking, and cooking fuels . . . mold; air fresheners and scented products; aerosolized cleaning and personal care products; and dust from carpeting, upholstery, and bedding.”

Air pollution: a host of associated ills.

While we often think of the respiratory problems that can result from this type of air pollution, Castner and Polivka point out literature that […]

2018-09-04T09:14:24-04:00September 4th, 2018|environmental health, Nursing|1 Comment
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Multi-Drug-Resistant Organisms and Contact Precautions

When MRSA was new on the scene, strict isolation precautions were the norm.

Photo by Rick Sforza, Redlands Daily Facts / SCNG.

Years ago, when we first started to see patients with methicillin-resistant Staphylococcus aureus (MRSA) infections at the hospital where I worked, we kept them in what was then called “strict isolation.” These patients were kept on one unit and cohorted in two rooms at the end of the hall. Staff wore gowns, gloves, masks, and hair covering. How we hated having to put on all that gear!

The current challenge of MDROs.

Today, we understand more about transmission, and isolation precautions are better tailored to the epidemiology of each drug-resistant organism. Unfortunately, though, since that time antibiotic resistance has rapidly increased, and we now find ourselves not only with a lot more MRSA to contend with, but with patients whose infections are susceptible to only one or two antibiotics (and occasionally, to none).

Some of these multi-drug-resistant organisms (MDROs) seem to be persistent colonizers—that is, the organism “takes up residence” on or in the body without causing infection, and can still be transmitted to others. In some cases these patients will need to be on isolation precautions every time they are admitted […]

2018-08-06T09:07:11-04:00August 6th, 2018|infection control, Nursing, Public health|0 Comments
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NPs ‘Move Mountains’

Rear Admiral Susan Orsega, chief nurse officer of U.S. Public Health Service

Last week I attended the annual conference of the American Association of Nurse Practitioners (AANP) in Denver. Yes, I was there for the record attendance (over 5,000) and the record heat wave (104 degrees). As with most large nursing conferences, there were numerous concurrent sessions—but here, many of them were like skills labs, including things not part of most RNs’ skill set, like performing a thoracentesis.

What was also different from other meetings was that the legislative and policy sessions, which were of high interest to me in order to find out how NPs are doing with scope of practice authority, were closed to media. No one could say exactly why.

Audio interview with U.S Public Health Service CNO Susan Orsega.

I did get a chance to speak with the keynote speaker, Rear Admiral (RADM) Susan Orsega, MSN, FNP-BC, FAANP, FAAN, chief nurse officer and assistant surgeon general of the U.S. Public Health Service. She focused on the critical role of NPs in addressing health inequities. She urged NPs to become active advocates to improve health, and, mindful of our Colorado setting, she charged them to “Go, move mountains.” You can […]

2018-07-06T08:27:26-04:00July 6th, 2018|Conference reports, 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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