International Health, Nurse Staffing, the Power of Social Media

I previously posted on this blog in anticipation of attending my first international nursing meeting—the  2017 International Council of Nurses Congress in Barcelona—and wrote about it later in a joint post with AJN‘s editor-in-chief Shawn Kennedy. There will also be a full report in the August issue of AJN.

Based on subsequent reflection, here are some lasting takeaways:

International health is an American nursing problem.

“Shamian asked what American nurses do for their fellow nurses around the world.”

There was a lot I didn’t know about global health. I was thankful that I’d taken some time to study a few key concepts, especially the sustainable development goals (SDGs).

In the opening session, ICN president Judith Shamian charged all nurses to take seats at policy tables and draw upon their expertise. Through her passion, I began to see a part I could play in policy making simply by keeping abreast of issues and sharpening my nursing voice.

From the plenary speech by former Secretary of U.S. Health and Human Services, Mary Wakefield, I began to see the necessity of grounding policy work with reliable, relevant evidence. And in our interview with Shamian, policy and evidence met collaboration as […]

2023-01-30T10:35:53-05:00June 30th, 2017|Conference reports, Nursing|7 Comments

Viewpoint: A Limitation of Preprocedure Checklists

I once worked at a hospital where some of the surgeons regarded safety checklists as an inconvenience. They saw them as bothersome intrusions by the nursing staff into the surgical suite. One OR nurse was even “counselled” by her supervisor (in the presence of the complaining surgeon) to avoid upsetting the doctors by using the preprocedure time-out.

How important are these tools? Are we using them well, or do we speed through them as rote exercises? Might we even expect too much of them? In AJN’s July Viewpoint, nurse Elizabeth Anne Crooks relates a frightening episode (she was the patient) that led her to think about time-outs in a different way.

Crooks was about to undergo a colonoscopy. The clinical team seemed relatively unconcerned about her bradycardia, which was a significant change from her normal heart rate. After completing the usual time-out protocol, sedation was initiated and the physician began the procedure. Suddenly, Crooks’ heart rate and blood pressure dropped precipitously.

I remember waking in distress and hearing the monitor alarming. The team was working rapidly to stabilize me with fluids and medications.

A routine procedure had suddenly become an emergency.

In reflecting upon her experience, Crooks wonders whether the preprocedure time-out may have given her clinical team a false sense of security—one that led them to downplay a clinically significant change. And yet, as we know, these time-outs focus on ensuring that the correct patient is receiving the correct procedure, and not on other safety […]

2017-06-28T09:19:40-04:00June 28th, 2017|Nursing, patient safety, Patients|3 Comments

Exploring Irritable Bowel Syndrome

Illustration by Sara Jarret.

Irritable bowel syndrome (IBS) is one of those conditions that is maddening for patients and clinicians alike. Its pathophysiology is unclear, the symptom picture varies widely from patient to patient, there is no test to confirm the diagnosis, and treatment is directed at managing symptoms because there is no cure.

To make things even more difficult for the person with IBS, there is a recognized psychological component of the disease. Therefore some friends, family members, and clinicians might tell people with IBS that their suffering is “all in their head.” And yet there is demonstrable proof (via neuroimaging studies) of differences in central processing mechanisms related to the “brain–gut axis” between people who have IBS and those who do not.

Kristen Ronn Weaver and colleagues explore these and other aspects of IBS in a clinical feature article in AJN’s June issue. The authors review the latest findings related to IBS etiology and pathophysiology, the relationship between IBS symptoms and stress, and the updated Rome IV criteria that help guide diagnosis. Of particular interest is the authors’ presentation of research confirming the value of several nonpharmacologic interventions, including dietary modifications, probiotics, moderately increased physical activity, yoga, and traditional Chinese medicine.

See “Irritable Bowel Syndrome” in the June issue to learn more, and to find out how nurse-led initiatives can lead to long-term health benefits for people with IBS.

 

2017-06-26T09:07:44-04:00June 26th, 2017|Nursing, patient experience|0 Comments

July Issue Highlights: Health and the Microbiome, Poststroke Depression, Need for Diverse Blood Donors, More

The July issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Health and the Human Microbiome: A Primer for Nurses

The profound impact of the human microbiome on health makes it imperative that nurses understand the basic structures and functions of the various microbial communities. This article provides an overview of the current state of knowledge about the human microbiome—with a focus on the microbiota in the GI tract and the vagina, the two most commonly studied body sites—and discusses implications for nursing practice.

CE Feature: Early Intervention in Patients with Poststroke Depression

Nearly one-third of stroke survivors experience depression. Poststroke depression is associated with longer hospital stays, poor physical and cognitive recovery, poor quality of life, high caregiver distress, increased risk of recurrent stroke, and higher rates of morbidity and mortality. However, it often goes unrecognized and untreated. The authors of this article explain how poststroke depression often manifests, describe associated risk factors, and discuss the screening tools and therapeutic interventions nurses can use to identify and help manage depression in patients following stroke.

Clinical Feature: The Growing Need for Diverse Blood Donors

The chief nurse of the American Red Cross discusses how changing demographics […]

2017-07-27T11:21:04-04:00June 23rd, 2017|Nursing|0 Comments

Why Do Pregnant Women Smoke?

 “My mother smoked [when she was pregnant] with me and I am fine.”

“I’d rather smoke a cigarette than take a drink of alcohol to relieve stress.”

“So you’re bored, what are you going to do? Sit down and smoke a cigarette.”

“It relaxes me.”

Tobacco use during pregnancy has been associated with many adverse effects, including abruptio placentae, fetal malpresentation, low Apgar scores, stillbirth, and birth defects such as gastroschisis and cleft lip or palate. Most nurses probably see these as no-brainer reasons for women to stop smoking once they become pregnant. Yet a new research study illustrates that the reasons pregnant women might continue to smoke are very individual, and that clinicians are not always skillful in supporting smoking cessation.

In this month’s AJN, researcher Geraldine Rose Britton and colleagues share the results of their qualitative study on the experiences of pregnant smokers and their health care providers. The researchers used a focus group methodology to learn about the smokers’ experiences and to better understand what motivated them to quit or prevented them from doing so.  There were also separate clinician focus groups to explore the approach of the 45 providers (71% RNs, 11% physicians, plus one NP, one nurse manager, four LPNs, and one PA) to pregnant women who smoke.

Not surprisingly, the researchers discovered that the issue is frustrating to both pregnant women and their maternity care providers. Some physicians and nurses […]

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