Off the Charts

Preventable and Aggressive Care for Cancer Patients: To the Bitter End

There have been a couple of recent studies that confirm what I have observed as a palliative care nurse practitioner (NP) in an academic medical center: that there’s still a tendency to pursue very aggressive care with older people with cancer. While every situation is different, the evidence shows that people with cancer could also benefit from palliative care and advance care planning to make sure they’re getting the best and right care for them.

Palliative care could prevent many ED visits.

The first study to catch my eye as a former ED nurse was Trends and Characteristics of Potentially Preventable Emergency Department (ED) Visits Among Patients With Cancer in the US. This study reviewed data on almost a billion (854,911,106) ED visits, of which 4.2% were made by patients with cancer. The mean age of those patients, not surprisingly, was 66. The study found that more than half of ED visits among patients with cancer, 51.6%, were identified as potentially preventable, with the absolute number of potentially preventable ED visits increasing substantially between 2012 and 2019.

The authors concluded that this highlights “the need for cancer care programs to implement evidence-based interventions to better manage cancer treatment complications, such as uncontrolled pain, in outpatient and ambulatory […]

Guest Author2023-04-07T09:34:11-04:00April 7th, 2023|end of life, Nursing, palliative care, patient experience, Patients|2 Comments

Pediatric Mental Health Tops ECRI’s 2023 Top 10 Patient Safety Concerns

Photo by Eric Ward on Unsplash

Each year, the ECRI Institute creates a list of top 10 patient safety concerns along with actionable recommendations for institutions to reduce these risks.

Some years, the list includes repeat offenders such as medication errors and concerns surrounding staffing. In the past few years, the list has reflected the reality of living during a global pandemic, with 2022’s top 10 concerns including clinician’s mental health, supply chain disruptions, and vaccine coverage gaps. This year’s list moves away from the pandemic somewhat, but still includes some fallout from COVID-19, with the number one concern reflecting a crisis among our youth: pediatric mental health.

According to the report:

“Concern for pediatric mental health was already high during the 2010s due to the growing use of social media, limited access to pediatric behavioral health providers, drug and alcohol use, gun violence, and socioeconomic impact, among other stressors. However, pediatric mental health issues have been exacerbated by the COVID-19 pandemic, with a 29% increase in children age 3 to 17 experiencing anxiety and a 27% increase in depression in 2020 compared with 2016.”

The report lists some recommendations to confront this issue, including securing leadership support and resources to evaluate the organization’s pediatric […]

Amy M. Collins, managing editor2023-04-05T12:25:54-04:00April 5th, 2023|patient safety|0 Comments

The Nursing Shortage: Foreign-Educated Workers Aren’t a Long-Term Solution

CGFNS VisaScreen Applications by Country of Education, 2022. Reprinted from CGFNS International. CGFNS Nurse Migration Report 2022: Trends in Healthcare Migration to the United States.

“Rather than relying on importing foreign-educated nurses, high-income countries should aim to ensure an adequate domestic supply of new nurses as well as retention of those already in the workforce.”

Increased nurse migration as a stopgap in the United States.

Demand for nurses in the United States is expected to grow to 3.3 million within this decade. But without quick action to replenish the nursing workforce, analysts project a potential shortfall by 2025 of 10% to 20% or as many as 450,000 RNs. To close this gap, the United States would need to more than double the number of new graduates entering and staying in the nursing workforce every year for the next three years.

An immediate solution would be for the United States to authorize increased migration of qualified nurses from other countries. But faced with growing shortages of their own, countries that historically have exported nurses could impose restrictions, as the […]

Jacob Molyneux, senior editor/blog editor2023-03-30T10:39:01-04:00March 30th, 2023|Nursing, Nursing shortage, Public health|1 Comment

April Issue Highlights: Nurses’ Views on Substance Users, Decarbonizing Health Care, More

“I was always the strong one, the one with the answers, the one people came to for advice….” – from the April Reflections essay, “Take Off the Mask: Getting Real About Depression, Trauma, and Loss“

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

CE: How to Write an Effective Résumé

In today’s job market, nursing students and new graduate nurses need to develop an employer-focused résumé geared toward a specific job. This article can assist.

Nurses’ Self-Assessed Knowledge, Attitudes, and Educational Needs Regarding Patients with Substance Use Disorder

This research study’s findings indicate that, “in general, hospital nurses have negative attitudes toward patients with substance use disorder” and are in need of empathy-based education.

AJN Reports: Decarbonizing Health Care

Nurses can be involved in solutions to reduce greenhouse gas emissions in the health sector.

[…]

Jacob Molyneux, senior editor/blog editor2023-03-27T08:10:27-04:00March 27th, 2023|climate change, environmental health, environmental health, family caregiving, Nursing, pain management|0 Comments

Relaxing: An Undervalued Skill as a Nurse

Image copyright Tanya Parker

Taking the art of collage seriously.

I recently attended an art workshop at the Biggs Museum of American Art led by artist Melissa Sutherland Moss, whose work is currently on exhibit there. The award-winning artist shared her process and guided participants in creating collage art based on the themes of self-identify and reflection. With participant permission, the artwork was featured in an exhibit at the museum as a part of the Dover Citywide Black History Celebration in February.

This was not the same collaging I remembered from elementary school years. There was nothing “juvenile” about the process. In fact, the only thing that invoked nostalgia was the use of the materials (magazines, photos, and other resources) to bring my vision to fruition. My end product, shown above, was titled “Relaxation.”

A visual reflection on relaxation.

Nursing is a caring profession. We know well how to serve others (patients , families, colleagues, students), but often neglect to care for ourselves. There’s an underestimated strength in the ability to rest, “relax,” and recharge. Self-care is often an afterthought or a never-thought. It’s frequently downplayed and or dismissed. However, with self-care we are able to be a better […]

Guest Author2023-03-23T09:58:39-04:00March 23rd, 2023|Nursing, wellness|7 Comments

Palliative care could prevent many ED visits.

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Increased nurse migration as a stopgap in the United States.

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Taking the art of collage seriously.

A visual reflection on relaxation.

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