Invisible Battles: Military Toxic Exposures and Health Provider Roles

Photo courtesy of U.S. Dept. of Veterans Affairs

The intersection of military service and environmental exposures has become an increasingly critical area of concern. Environmental factors affect the health and well-being of military personnel in complex and multifaceted ways, and ill and injured military veterans may find their high aspirations undermined by mental and physical ailments that significantly affect their quality of life.

This is the case for several of my family and friends, including my uncle, a veteran from the era of Desert Shield/Desert Storm, who has suffered for years because of the effects of environmental and other exposures while in the military.

A direct strike against health and wellness.

Many veterans say that they had a picture-perfect bill of health before exposure to environmental hazards during military service. Here is a glance at some of the exposures that service members faced in recent decades while in a garrison or on deployments to conflict zones.

Exposures and health impacts on service members:

2024-01-08T10:35:25-05:00January 8th, 2024|environmental health, Nursing|0 Comments
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Military Environmental Exposures: Recommended Reading in AJN’s November Issue

The November issue of AJN is now live.

What should nurses know about caring for people who have been exposed to potentially harmful agents—such as air pollutants, chemicals, radiation, warfare agents, and materials containing asbestos and lead—during military service? Read “Military Environmental Exposures” to find out.

Our November CE article, “Recognizing Transfusion-Associated Circulatory Overload,” reviews the most current definitions of this adverse transfusion reaction and outlines its characteristics and management.

“What Health Care Staff Who Experienced Assisted Patient Falls Can Teach Us: Implications for Fall and Fall Injury Risk,” presents qualitative findings from a QI project aimed at improving guidance for staff on the risks of assisting falling patients.

“Nursing Research, Step by Step: Sample Size Planning in Quantitative Nursing Research,” one in a series on clinical research by nurses, describes how to determine an appropriate sample size for a quantitative research project, and introduces the concepts of error, power, and effect size.

In “Optimizing Blood Culture Collection Volumes,” the authors discuss a QI project they conducted to understand the causes of underfilled and overfilled blood cultures obtained by nurses and PCTs and to reduce their incidence.

See also the […]

2023-10-26T11:59:45-04:00October 26th, 2023|Nursing|0 Comments
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Honoring Notable Black Nurses of History

USS Red Rover hospital ship. National Library of Medicine.

Nurses Week is scheduled to correspond with the birth of Florence Nightingale (1820-1910).  We do this to honor her work in professionalizing and modernizing nursing. Her contribution to our profession is considerable, and it is right that we pay respect to her. But it is equally right that we put Nurse Nightingale in context so that Nurses Week can celebrate all nurses, and not just the often well-off white women on which most nursing history focuses. This four-part blog series during the month of May will honor a handful of women of color who accomplished remarkable things during Florence Nightingale’s lifetime.

Ann Bradford Stokes

Ann Bradford Stokes (1830-1903) was born into slavery on a Tennessee plantation. In 1863, she escaped and was taken aboard a Union hospital ship. She eventually became one of the first women to be listed as active duty personnel, and the one of the first Black women to serve as a nurse in the navy. Along with five other Black women who had escaped slavery (Alice Kennedy, Sarah Kinno, Ellen Campbell, Dennis Downs, and Betsy Young Fowler), she cared for about […]

2023-05-05T11:31:21-04:00May 1st, 2023|Black nurses, Nursing, nursing stories|0 Comments
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If Nurses Are War Heroes, They Deserve Real and Lasting Support

Matthew Waring/Unsplash

The rhetoric of war is regularly applied to health care, whether we’re talking about a patient “fighting” cancer or “frontline” workers like nurses engaged in a “battle” or a “war” against a new infectious disease. This is a habit beloved of speech makers, academics, and journalists, and it’s likely to continue.

With strong metaphors comers real responsibility.

Rather than decrying this practice in favor of a more purely accurate use of language, the author of this month’s Viewpoint, Lorri Birkholz, DNP, RN, NE-BC, an assistant professor of nursing at Chatham University in Pittsburgh, argues that the choice to use such language comes with responsibility.

“If war language is going to be used to define this pandemic and the nurses caring for patients, then legislation must ensure care for their acute and long-term physical and mental well-being.”

Birkholz notes that federal COVID-relief legislation limited provisions for frontline workers to temporary hazard pay and mandated sick leave—far short, by way of comparison, of that received by 9/11 first responders or returning war veterans. […]

2022-01-24T09:56:24-05:00January 24th, 2022|Nursing|0 Comments
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Therapeutic Humor in Nursing: More Important Than Ever

Nursing during a pandemic is no laughing matter…but it was for me.

Photo by Mathias Konrath on Unsplash

Assessing mental health patients over the phone at the VA was always challenging. I worked with the primary care providers, assessing new patients and getting them the right mental health resources.

Little did I know it was going to be taken to another level during the pandemic. It was Covid mental health mayhem: Covid cold calls, suicidal calls, PTSD patients plummeting with increased isolation and hospitalizations. There was increased depression, anxiety, and insomnia (and that was just the RN staff members, LOL!).

I couldn’t control this pandemic, my frustration over anti-vaxxers, the fatigue, fears, or sadness. But what I realized I could control was my daily interactions with the patients. I had to do review the PHQ-9 questionnaire for major depression symptoms and the GAD for anxiety. Once I’d finished the mental health assessments, I’d concentrate on the behavioral activation their results suggested.

Cultivating patient connection through laughter.

Having taken part in research on the therapeutic benefits of humor, one strategy I often used with these patients was to ask them, “What made you laugh today?”

At first, many couldn’t think of anything. So I decided to ask about more specific […]

2021-12-01T08:29:30-05:00December 1st, 2021|Nursing|2 Comments
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AJN February Issue Highlights: Communication Challenges Due to PPE, Pressure Injury Prevention, Concussions, More

“Nurses are essential to administering the vaccines, and we need to be prepared with accurate information about the science behind them: how they work, what we know and don’t know about them, and what might change as more data emerge.”—editor-in-chief Shawn Kennedy in her editorial, “Building Trust”

The February issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

Original Research: Concussions at School: The Experiences and Knowledge of School Nurses

This study explores the pediatric concussion-related knowledge, confidence, and management experiences among urban and rural school nurses in Washington State.

Communication Challenges in High-Containment Clinical Environments

The authors discuss the communication challenges that arise with the wearing of PPE and describe strategies they and their colleagues in the National Institutes of Health’s Special Clinical Studies Unit used to improve communication with other staff, patients, and external partners.

[…]

2021-02-01T14:29:13-05:00February 1st, 2021|Nursing|0 Comments
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Informing Policy, Driving Change: No Longer Optional for Nurses

Nurses have the knowledge, skills, and obligation.

Rep. Lauren Underwood, left, with AAN president Karen Cox

The American Academy of Nursing (AAN) kicked off its annual policy conference last week by honoring Rep. Eddie Bernice Johnson, (D-TX), the first registered nurse elected to Congress, and hearing from the nurse most recently elected to the House, Rep. Lauren Underwood, (D-IL). Their presence underscored a viewpoint that is gaining traction in prominent circles, from the World Health Organization to the National Academy of Medicine: Nurses have the knowledge, skills, and obligation to inform policy and drive change.

During her talk, Underwood laid out her policy priorities and expressed her fervent belief that for nurses, “engaging in policy is not optional.”

Underwood serves on three House committees—Veterans’ Affairs, Homeland Security, and Education and Labor—and within those on subcommittees dealing with emergency preparedness, disability assistance, and other topics where she uses her health expertise to influence policy on a range of issues. These include gun violence prevention, black maternal health, infant mortality, drug pricing, and suicide among veterans.

A data-driven approach.

Underwood’s approach to policymaking is data driven. Prompted by research on medication adherence, she sponsored a bill to allow veterans to receive a full-year’s supply of contraceptives rather than having to refill their prescriptions every three months.

When […]

2019-10-29T15:50:34-04:00October 29th, 2019|Nursing, nursing perspective, nursing roles, Public health|0 Comments
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March Issue: Type 2 Diabetes Drugs Update, Arterial Blood Gas Analysis, Fall Prevention Checklist, More

“It’s a challenge—for both nurses and family caregivers—to prepare caregivers for their new duties, often in a very short time span. I often wonder if it’s really possible to do this—and even if it is, should that be our goal?”—AJN editor-in-chief Shawn Kennedy in her March editorial

The March issue of AJN is now live. Here are some highlights.

CE: Original Research: New Acute Symptoms in Older Adults with Cognitive Impairment: What Should Family Caregivers Do?

The authors assessed the frequency with which family caregivers of older veterans with cognitive impairment sought guidance for new physical or behavioral symptoms and described the characteristics of such events, including the diagnoses and advice given.

CE: Type 2 Diabetes: A Pharmacologic Update

A review of established and newer type 2 diabetes medications, plus nursing implications for patient education and monitoring for adverse effects.

Cultivating Quality: Using a Fall Prevention Checklist to Reduce Hospital Falls: Results of a Quality Improvement Project

Nurses at a Midwestern teaching hospital implemented a fall prevention checklist to improve adherence to an existing protocol and evaluated its impact on fall incidence.

Clarifying the Confusion of Arterial Blood Gas Analysis: Is it Compensation or Combination?

This article reviews basic arterial blood gas interpretation and discusses the combinations of imbalances and compensatory mechanisms that may occur.

2019-02-25T09:25:07-05:00February 25th, 2019|Nursing|0 Comments
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Hidden in Plain Sight: What Nurses Need to Know About Food Insecurity

Are any of the people you see in your office or clinic “food insecure?” How about the college friends of your children? Or perhaps your own coworker?

Food insecurity is all around us.

The United States Department of Agriculture describes food insecurity as the lack of “consistent, dependable access to adequate food for active, healthy living.” Recent data indicate that food insecurity affects about 13% of U.S. households. In some states, the rate approaches 20%. Certain populations are particularly vulnerable: 27% of veterans who served in Iraq or Afghanistan and as many as 37% of college students are food insecure.

Twice monthly, the Muslim Food Pantry in Flint, MI, distributes free food to anyone who needs it. The pantry is run by volunteers and offers food, bottled water, and hygiene products to those with limited or no food or clean water—the latter a result of the Flint […]

2019-01-14T11:45:33-05:00January 14th, 2019|Nursing, Public health|0 Comments
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‘So Many Things a Pill Can’t Solve’: An Integrative Therapy Nurse in Acute Care

“I don’t think that people realize how powerful human touch can be.”

“This therapy is invaluable to me—not just physically, but for my mental state too.”

“I think that we as Americans need more of this [integrative] therapy because there are so many things that a pill can’t solve.”

This is some of the feedback offered by patients after massage therapy sessions at the Minneapolis Veterans Affairs Medical Center. In this month’s AJN, integrative therapy nurse Hallie Boyd describes how her program has become a vital part of symptom management on the spinal cord injury and disorders unit there.

Help for patients in coping with chronic pain.

As a staff nurse on this unit, Boyd had encountered many patients who were trying to cope with chronic pain. While the hospital had long educated nurses on the use of integrative modalities such as guided imagery, acupressure, and aromatherapy, it was difficult for them to employ these techniques on a regular basis during busy and unpredictable shifts.

So, while continuing her work on the spinal cord unit, Boyd returned to school to focus on hospital-based therapeutic massage for medically complex patients. Training alongside a diverse group of practitioners, she developed and refined the idea of a full-time integrative therapy nurse as […]

2018-11-28T11:01:10-05:00November 28th, 2018|Nursing|1 Comment
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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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