‘Patient Activation’: Real Paradigm Shift or Updated Jargon?

By Jacob Molyneux, AJN senior editor

I attended a Health Affairs briefing yesterday in Washington, DC. Based on the February issue of the journal, it was called “A New Era of Patient Engagement.” A lot of research money appears to have been flowing to this area in recent years.

Our January article on "Navigating the PSA Screening Dilemma" includes a discussion of 'shared decision making' Our January article on “Navigating the PSA Screening Dilemma” includes a discussion of ‘shared decision making’

The basic idea isn’t entirely new to anyone who’s been hearing the term “patient-centered care” for a long time: as Susan Dentzer writes in “Rx for the ‘Blockbuster Drug’ of Patient Engagement,” a useful article summarizing the main ideas raised in the Health Affairs issue: “Wherever engagement takes place, the emerging evidence is that patients who are actively involved in their health and health care achieve better health outcomes, and have lower health costs, than those who aren’t.”

One might add to these projected benefits: better experiences as patients.

Something’s got to change, so why not this? If many nurses feel they’ve heard all this before, the sense of a health care system in necessary flux is particularly acute right now, with mounting pressures from an aging Baby Boom generation with its […]

Gym Class, or Physical Education?

Photo by Krossbow, via Flickr

By Michael Fergenson, AJN senior editorial coordinator

Gym class. Some of us may have memories of a brusque man tossing a ball into the middle of the gym, telling us to play and occasionally blowing a whistle. Popular culture certainly portrays the “gym teacher” in this way—or worse, sometimes they’re cast as the villain. I put gym teacher in quotes in the last sentence because my dad would get angry with me if he heard that term, or “gym class” for that matter. My father considers himself a physical educator. When people call him a gym teacher, which is most of the time, he replies with the quip: “The gymnasium is the room that I teach in, but I am a physical education teacher.”

There’s something more important going on here than mere semantics. Is this pop cultural view of the gym teacher causing harm to students? I believe so.

My father has been a physical educator for a little more than 20 years. For a long time I had the same negative view of gym teachers as most people. That was until I began to study education myself. I definitely wasn’t going to be a gym teacher—oh no, it was literature for me. I would be a high school English teacher, but that didn’t sound quite right. […]

The Elusive Strict Diet

By Amy M. Collins, associate editor

Several days ago, we linked on our Facebook page to an abstract of a JAMA article that found that women hospitalized for myocardial infarction were more likely than men to present without chest pain. A few days later, my 59-year-old mother was told by her general practitioner that her ECG had shown an electric “blip” that could be due to scarring from an unnoticed heart attack. My mother—always too lax about these things (unlike her hypochondriac daughter)—calmly told me she always has random chest pains and it could have happened at any time.

A visit to the cardiologist a few days later eased our fears. She hadn’t had a heart attack, but was diagnosed with right bundle branch block and has to undergo further testing. With high C-reactive protein levels, elevated cholesterol, and a history of heart disease in the family, one can’t be too careful. A stress test and cardiac ultrasound have been ordered.

In discussing her cholesterol level, which had increased since my mother’s last wellness exam, the cardiologist suggested she start taking statins. Not keen on medication, and worried by recent reports of adverse effects from these drugs, she said she’d rather only start with that if there were no other options. His suggestion was to maybe try some over-the-counter […]

Sarcopenia and Me – Or Why Exercise Really Matters as We Age

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

Recently I started an exercise program with a personal trainer. I’ve been a runner for 25 years, even ran five marathons. I’ve never had a problem being disciplined about running four or five days a week, no matter what the weather. But I’ve never been able to stick to any other exercise program for more than a week or so. Working with weights, yoga, step classes, just doing push-ups in my living room when I get back from a run—never stuck with any of them.

Getting older isn’t kind to those who don’t exercise. Years ago my lack of upper-body fitness was hardly noticeable. Shoveling snow, raking leaves, playing racquetball, carrying my kids around, all of it kept me in good enough shape. That’s not the case now that I’m in my fifties. Lifting my grandson above my head—not happening. Hanging a new shower curtain – three clips – rest – three clips – rest…

When I found I couldn’t blow-dry my very short hair without lowering my arm repeatedly because of muscle fatigue, it was time to do something about it.  That’s when I decided to invest in a personal trainer. It was expensive—but I figured I would just do it long enough to make exercise, other than running, a […]

Swimming from Alcatraz

by jitze couperus via Flickr

By Marcy Phipps, RN, whose essay “The Soul on the Head of a Pin” appeared in the May 2010 issue of AJN. She’s a frequent writer  for this blog.

I’m going to swim from Alcatraz.

It’s daunting, yet irresistible, and a challenge I’m not taking lightly. As part of my preparation, I’ve purchased the book Open Water Swimming: Lessons from Alcatraz. In it, Joe Oakes and Gary Emich deliver a wealth of information and practical advice in a very direct way. They’ve provided much to mull over during my long training swims—and I’ve been struck by how well the principles they stress can be applied to nursing:

“Never swim alone and always swim with a competent pilot.”

It would obviously be unwise to attempt a treacherous swim alone. Similarly, it’s vital to work with a team who can be trusted to back one another up. It’s also vital to know who the resource people are and to have a mentor, whether formally or informally.

“There are plenty of sharks in San Francisco Bay.”

Unfortunately, there are occasionally sharks amongst hospital staff, as well. Shark-like behavior should be identified for what it is, and handled accordingly. It should never be taken personally.

“Wet suits are the most obvious way to keep yourself insulated.”

The authors go on to discuss the […]