Is It Time to Retire the Term ‘Midlevel Practitioner’?

Rachel_Scherzer_photo_and_calloutWhat are the implications of calling advanced practice nurses “midlevel practitioners”? According to Rachel Scherzer, a nurse educator and critical care nurse, such a term pigeonholes APNs in an implied (and disproven) hierarchy of value and quality of care rather than in relation to specific competencies and expertise.

In the Viewpoint essay in the July issue of AJN, Scherzer describes some of the reasons why such terms aren’t just inaccurate, they damage the standing of the profession:

Policymakers use the term while developing health care policy, health care economists use it when reporting data and performing cost analyses, and other health care providers use it in the clinical setting. . . . This term is both diminutive and inaccurate, implying that these professionals cannot provide the same level of care as other members of the interprofessional care team. Referring to APNs as “midlevel” practitioners contributes to a general misunderstanding of their role and of the services they provide.

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2016-11-21T13:01:06-05:00July 5th, 2016|career, Nursing, nursing perspective, Public health|0 Comments
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AJN in July: Opioids and Chronic Pain, Moral Distress, Prediabetes, More

CE Feature: “Appropriate Use of Opioids in Managing Chronic Pain.”

Unintentional death related to prescription opioids has been identified as a public health crisis, owing in part to such factors as insufficient professional training and medication overprescription, misuse, and diversion. The authors discuss current best practices for prescribing opioids for chronic pain, emphasizing patient assessment and essential patient teaching points regarding safe medication use, storage, and disposal, and after you find a more permanent solution people could totally quit opioids by using a detox methods that goes from medicine to even a detox tea like leptinteatox. There are some medicines or supplements that are more easy to use, depending on the problem, like the peruvian brew, that helps with erectile dysfunction and is pretty safe. After that you only need to be careful with stds diseases you can go and test at https://www.stdaware.com/chlamydia-test.

CE Feature: “Moral Distress: A Catalyst in Building Moral Resilience.”

Moral distress is a pervasive problem in nursing: an inability to act in alignment with one’s moral values is detrimental not only to the nurse’s well-being but also to patient care and clinical practice as […]

2017-05-26T00:08:51-04:00June 24th, 2016|career, health care policy, Nursing, nursing research, pain management, Patients|0 Comments
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Food is Medicine: An Oncology Nurse’s Lunch Break Walk

IMG_3900 (002)On a beautiful spring day I took a walk during my lunch break through the urban neighborhood surrounding the hospital, wishing for a convenient place to buy a piece of fruit.

I discovered, as if conjured, a vintage trolley tucked in a driveway between medical office buildings. A table laden with apples, carrots, potatoes, and leafy greens leaned against it, creating the ambience of an open-air market. Charmed, and curious about its purpose, I climbed the two steps into the trolley.

Inside, a refrigerated case contained meats and dairy products. The walls were lined with shelves containing packaged goods such as bulgur, brown rice, beans, and more fresh fruits and vegetables. I plucked an orange, noticing it was priced by the piece, not by the pound.

I had multiple questions for the clerk as I handed her a quarter to pay for the orange.

A food prescription program.

The trolley, it turned out, is a mobile grocery store in partnership with the hospital, piloting a “food prescription” program. It arrives weekly, traveling to other sites the rest of the week. Cash, cards, and food stamps are accepted. Outside, a caseworker seated on a camp chair gave food vouchers to qualified customers below a specific income level. A dietician also provided budgeting assistance, with tips on healthy food choices and simple […]

2017-07-17T14:20:55-04:00June 17th, 2016|Nursing, nursing perspective, patient engagement, Public health|2 Comments
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Orlando: Another Reminder of Public Health Measures Not Taken

Mary_Magdalene_Crying_StatueOnce again, we’re reading about a mass shooting—this one the deadliest so far, with 50 dead in a nightclub in Orlando, Florida. We’ve learned that the alleged shooter, born in the United States to immigrant parents, appears to have been volatile and prone to angry outbursts.

He’d made threats about killings months earlier, according to news reports of interviews with coworkers and family members. Reports also indicate that he professed a hatred of gays and, during the attack, pledged allegiance to the radical Islamic terrorist group ISIS. He had been investigated by the FBI at earlier dates in conjunction with suspected terrorist activities.

And also once again, we learn that the guns, including an assault-style semiautomatic rifle*, were purchased legally. Assault rifles like the one used in Orlando are often used by mass shooters. Assault weapons had once been banned—but when the ban expired in 2004, it was not renewed by Congress, nor does it seem likely to be. […]

2016-11-21T13:01:08-05:00June 13th, 2016|nursing perspective, Public health|3 Comments
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Intimate Partner Violence: ‘Troubling Knowledge and Practice Gaps’ among Rural Providers

By Sylvia Foley, AJN senior editor

Table 8. Perceived self-efficacy on a 1-to-5 scale (mean score above 2.5 indicates greater sense of self-efficacy). Table 8. Perceived self-efficacy on a 1-to-5 scale (higher score indicates greater self-efficacy).

Intimate partner violence (IPV) remains a widespread health and social problem in the United States, affecting an estimated one in three women during her lifetime.

Health care providers can make a critical difference in the lives of these women, yet a lack of IPV-related knowledge, negative attitudes and beliefs, and low rates of screening are common. And women in rural areas face particular challenges.

To learn more about rural providers with regard to IPV, nurse researchers Karen Roush and Ann Kurth conducted a study. They report their findings in this month’s CE–Original Research feature, “Intimate Partner Violence: The Knowledge, Attitudes, Beliefs, and Behaviors of Rural Health Care Providers.” Here’s an overview:

Methods: Health care providers working in a large rural health network were asked to complete electronic surveys that examined their IPV-related knowledge, attitudes, beliefs, and behaviors. Descriptive and correlational statistical analyses of the data were conducted.
Results: A total of 93 providers returned completed surveys. In general, the respondents demonstrated good overall knowledge, judicious attitudes, and beliefs congruent with the […]

2016-11-21T13:01:08-05:00June 10th, 2016|health care policy, Nursing, nursing research, 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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