The Pain Left Behind: Reflections on a Medical Mission and an Island’s Overwhelmed Nurses

“My family left after the volcanic eruption,” Sister said to me with a heavy heart. “But I asked myself, who will take care of my fellow Montserratians who stayed behind?”

These poignant words reflect the resilience and dedication of the nurses I encountered during my recent medical mission to Montserrat. During my time on the island, I collaborated with cardiologist Icilma Fergus Rowe of Mount Sinai Medical Center in New York City, who returns each year to provide much-needed cardiac care. The team serves over 100 patients in just five days, providing essential cardiac consultations, follow-up visits, and diagnostic echocardiograms, as well as referrals for further treatment or testing in Antigua or sometimes the United Kingdom (UK).

Local nurses under strain.

While many patients waited all year for consultation with our team and our presence was met with gratitude, local nurses who facilitated this care also revealed to me that our visit placed additional strain on the already overwhelmed nursing staff. Now, as I reflect on the benefits brought by medical missions like ours, I remain aware of the poignant reality that when you leave, you leave behind hurting colleagues whose pain stays with you.

The lasting effects of a devastating volcano eruption.

This small island in the Caribbean 25 miles southwest of Antigua, once a thriving community, has faced numerous […]

2025-01-08T10:20:14-05:00January 8th, 2025|COVID-19, disaster preparedness, Nursing, Public health, volunteering|0 Comments
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The Critical Role of Nurses in Intravenous Fluid Conservation

Image credit: AHVAP.org (Association of Healthcare Value Analysis Professionals)

Baxter International’s North Cove Facility in North Carolina was severely damaged by Hurricane Helene on September 26, 2024. The temporary closure of that facility and production interruption has resulted in significant shortages in intravenous, dialysis, and irrigation fluids and supply disruption impacting health care facilities across the United States. The responsibility to effectively and responsibly manage these critical resources has fallen heavily on the shoulders of nursing teams and health care supply chain professionals.

The crucial role of nurses during shortages.

Nurses are responsible not only for administering IV fluids but also for monitoring fluid needs, assessing patient status, and adjusting plans of care accordingly. When these lifesaving fluids become scarce, nurses must ensure that every intravenous fluid or irrigation product is used wisely, balancing patient safety with resource availability.

Why conservation is essential.

The consequences of IV fluid shortages extend beyond inconvenience. Fluids such as 0.9% normal saline and Lactated Ringer’s are vital in stabilizing patients, hydrating those who cannot take fluids orally and serving as carriers for essential medications. Shortages can lead to critical delays in patient care, increased length of stay, and negative outcomes for patients who rely […]

2024-11-18T13:53:43-05:00November 18th, 2024|climate change, disaster preparedness, environmental health, Nursing, Public health|0 Comments
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Pertussis Rates Have Been Rising: What Nurses Need to Know

Pertussis, or whooping cough, remains one of the leading causes of vaccine-preventable deaths worldwide, with most deaths occurring in young babies who are either unvaccinated or incompletely vaccinated.

During the COVID-19 pandemic, many of the infection prevention and control measures such as masking, social distancing, and remote learning for children resulted in decreases in reported cases of pertussis. However, in 2023 and 2024 a return to routine activities has resulted in an increase in pertussis cases. Preliminary data from the Centers for Disease Control and Prevention (CDC) show that more than five times as many cases of pertussis have been reported as of October 19, 2024, compared to the same time period in 2023. This is higher than was seen during the same time period in 2019, prior to the pandemic. Compounding this problem are the alarming trends showing lower rates of routine vaccination among adults and children, trends which indicate reduced vaccine confidence and increases in vaccine hesitancy in the U.S. population.

Key points of knowledge and action for nurses

Epidemiology of pertussis

Pertussis is caused by Bordetella pertussis, a gram-negative coccobacillus and is highly contagious and easily spread person-to-person via respiratory droplets or through direct contact with respiratory […]

2024-11-11T11:32:08-05:00November 11th, 2024|infectious diseases, Nursing, pediatrics, Public health|0 Comments
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The Epidemic of Gun Violence: A ‘Problem to Be Solved, Not a Battle to Be Won’

The alarming surge in child gun deaths

For decades, gun violence in America has been framed “as a battle to be won rather than a problem to be solved,” in the words of a poignant New York Times op-ed by Nicholas Kristof, who argues that we should acknowledge the blunt reality that guns aren’t going away. Therefore, he writes, it’s time to “bypass the culture wars and try a harm-reduction model familiar from public health efforts to reduce deaths from other dangerous products such as cars and cigarettes.”

The current combative public debate has been accompanied by devastating increases in gun violence, particularly for the youngest members of our society. According to an October 2023 study published in Pediatrics, between 2011 and 2021, gun deaths among Americans under the age of 18 surged by 87%, making gun violence the leading cause of death for American children. In stark contrast, there has been an overall steady decline of child deaths from motor vehicle fatalities, with a 51% reduction from 1999 through 2020, showcasing the potential for effective interventions when society’s most confounding issues are treated through a public health lens.

The stark reality of gun violence

The reality of gun violence in America is stark and sobering. Gun […]

2024-08-08T09:48:27-04:00August 8th, 2024|gun violence, Nursing, pediatrics, Public health, school nurses|1 Comment
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Dengue Fever: What Nurses Need to Know Now

This summer the Centers for Disease Control and Prevention (CDC) has issued a health advisory as countries in the Americas report 9.7 million cases of dengue, the highest number in any year. The United States and Puerto Rico have reported 2,559 cases of dengue since January. The CDC expects the numbers to continue to rise as the environment warms.

Nurses in every specialty, but especially those who prepare individuals and families for international travel, will want to know about this latest dengue surge. All U.S. nurses will want to know how to triage, manage, and follow-up these patients to prevent local outbreaks and life-threatening complications.

Dengue (“den-gay”) fever is an age-old viral illness rapidly expanding its global impact beyond the tropics. According to the Rockefeller Foundation, “dengue fever is the most rapidly spreading mosquito-borne viral infection in the world.”

Also known as “breakbone fever” because of the painful arthralgias and myalgias associated with the infection, dengue is a common disease in the Americas, Africa, the Middle East, Asia, and the Pacific Islands, where it is a health risk for travelers and locals alike.

Currently 3.9 billion people are at risk in 129 countries, including certain areas of the United States. The WHO estimates that 400 […]

2024-07-18T15:10:04-04:00July 18th, 2024|climate change, infection control, infectious diseases, Nursing, 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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