Attention to Patients’ Mobility: Low-Tech But Essential

A critical care nurse led a multidisciplinary team to explore the effects of a dedicated ‘mobility team’ on functional and other outcomes in ICU patients.

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

julie kertesz/ via flickr creative common julie kertesz/ via flickr creative common

It’s long been known that immobility leads to deconditioning. Various studies indicate that muscle strength drops by 3% to 11% with each day of bed rest. As most of us have witnessed firsthand in both patients and family members, it can take months to regain pre–bed rest levels of functioning. For some people, the strength and mobility needed for independence never return.

In this month’s issue, a community hospital critical care nurse led a multidisciplinary team to explore the effects of a dedicated “mobility team” on functional and other outcomes in ICU patients. In “Implementation of an Early Mobility Program in an ICU,” Danielle Fraser and colleagues share what they learned.

The mobility team consisted of a physical therapist, a critical care RN, and an ICU rehab aide. Respiratory therapists worked closely with the team. Patients assigned to the early mobility intervention could progress through four successive levels of movement, from passive range-of-motion exercises to full ambulation.

Compared with ICU patients who received routine care, the patients in the intervention group were more functionally independent at discharge. In addition, this early mobility […]

2016-11-21T13:01:41-05:00December 7th, 2015|Nursing, nursing perspective, nursing research, patient engagement|0 Comments
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The Stay-at-Home Nurse

“You may not always take your work home with you, but you take your nurse self everywhere.”

Diane Stonecipher, BSN, RN, lives in Austin, Texas.

by rosmary/via Flickr by rosmary/via Flickr

The proverbial “what do you do?” always flummoxed me. My answer was usually some variation on this: “I used to be a nurse, but I have not worked outside the home while I’ve been raising my sons.”

But most people stopped listening after the “I used to be.” Sure, I could recite some things that I had done during the intervening years, but they were not really vocations I could make a claim to.

Even my children, who I had after first being a nurse for 15 years, never thought of me as a nurse. I did not leave the house for work, I did not get paid, I did not gripe about my job (in front of them), and I was available to them 24/7.

There are many professions that lend themselves to being a good mother. There are many interests, talents, and personalities that contribute to good mothering skills. Look at nature and you will see incredible maternal gifts in every species.

Still, I can’t help but think that I have been a better mother because I am a nurse and that my children have benefited in […]

2016-11-21T13:01:41-05:00December 4th, 2015|career, narratives, Nursing, nursing perspective|3 Comments
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Fracking, Health, and the Environment: More Bad News

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

U.S. EPA / via Wikimedia Commons U.S. EPA / via Wikimedia Commons

Last month, Physicians for Social Responsibility and Concerned Health Professionals of New York released the third edition of their Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking. This document summarizes more than 500 peer-reviewed studies on hydraulic fracturing (fracking),  along with many government and investigative journalism reports.

Fracking involves drilling into the earth and injecting a mixture of water, sand, and chemicals into the rock at high pressure to release the gas inside. There is extensive evidence to demonstrate health risks, environmental damage, and contributions to climate change caused by this practice.

The compendium is intended for policy makers, researchers, journalists, and the public. Specific fracking-related problems identified in this body of literature include the following:

  • Public health impacts, including respiratory disease and congenital abnormalities
  • Air pollution
  • Water contamination
  • Soil contamination and its effects on agriculture
  • Radioactive releases
  • Inherent engineering problems
  • Occupational health and safety hazards
  • Impacts from fracking-associated infrastructure, including noise, light, and diesel pollution
  • Earthquakes and seismic activity
  • Climate change (primarily from methane leaks)

[…]

2016-11-21T13:01:42-05:00December 2nd, 2015|Nursing, nursing perspective, Public health|3 Comments
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AJN in December: Inside an Ebola Unit, Acupressure, Early Mobility, EHRs, More

AJN1215.Cover.OnlineOn this month’s cover, nurse Elie Kasindi Kabululu cares for a patient at Centre Médical Evangélique in Nyankunde, Beni, Democratic Republic of Congo. Originally, this location served a population of 150,000 and also housed a nursing school; but in 2002, during war in the region, the facility was attacked. About 1,000 people were killed—including patients and staff—and the center was looted and destroyed.

Providing medical assistance in the world’s war-torn and neediest areas is commonplace for health care providers like Kabululu, just as it is for humanitarian organizations such as Médecins Sans Frontières (MSF), which works in 70 countries worldwide—nearly half of these in Africa. Shortly after the recent outbreak of Ebola in West Africa, MSF sent close to 300 international workers to help combat this public health emergency. To read one nurse’s experience traveling to Liberia for MSF to work in a treatment center, see “Inside an Ebola Treatment Unit: A Nurse’s Report.”

Some other articles of note in the December issue:

Original Research: “Implementation of an Early Mobility Program in an ICU.” This article, from our Cultivating Quality column, recounts how the effects of an early mobilization program delivered to critically ill patients at a community hospital by an independent ICU mobility team contributed to fewer delirium days and improvements in patient outcomes, sedation levels, and functional status.

CE Feature: “Incorporating Acupressure into Nursing Practice.” The effects of acupressure can’t always be explained in terms of Western anatomical […]

2016-11-21T13:01:42-05:00November 30th, 2015|infectious diseases|0 Comments
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Thanksgiving in the ICU: Woven into the Tapestry of Traditions

By Marcy Phipps, BSN, RN, CCRN. Editor’s note: This post, originally published in 2011, remains as timely as ever. The author is now chief flight nurse at Global Jetcare.) 

cranberries

I’ll be working this Thanksgiving. I’ve worked so many Thanksgivings that the ICU feels woven into the tapestry of my own traditions. I don’t really mind; the cafeteria serves a fitting feast that’s embellished by the homemade treats we bring in, and although we won’t actually be watching it, the Macy’s parade will be on. Somehow, the smells and sounds I associate with the holiday will mix and mingle with the usual bustle of critical care, and it’ll feel like Thanksgiving. It’s actually a nice day to be at the hospital—for the nurses, that is.

For our patients and their families, I know hospital holidays fall far short. We have one patient, in particular, who’s been with us for a while. Her husband’s been a fixture at her side throughout her stay, and I expect to find him stationed there this Thanksgiving. Hospital turkey and television won’t give him the comfort or peace that he seeks, and I don’t know that he’ll be giving thanks. For many weeks I’ve watched him skirt a fine line between gratitude and despair; things could always be worse, but they could certainly be better.

When I stop to count my blessings, I’m overwhelmed. I belong to a profession that I’m passionate about—one that brings me great […]

2016-11-21T13:01:43-05:00November 25th, 2015|career, narratives, nursing perspective, patient engagement|2 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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