Off the Charts

Getting Nurses with Substance Use Disorders the Help They Need

“Nurses have distinctive risk factors associated with the work environment that may increase the probability of developing an SUD.”

In my previous roles as the director of the emergency department and pediatric intensive care unit, I worked with nurses who were enrolled in the Intervention Project for Nurses (IPN), which is a substance use disorder (SUD) assistance program.

My colleagues would often ask me why I’d hire anyone who was enrolled in this program. My response was that these are the ones who are getting help and trying to recover. I feel safe with these nurses because I know they are being monitored and receiving treatment—it’s the other nurses that I worry about. […]

Guest Author2022-10-12T09:33:38-04:00October 12th, 2022|career, Ethics, Nursing, patient safety|0 Comments

Vot-ER: A Nonpartisan Voter Registration Resource for Health Care Settings

The news hits close to home for a mother-to-be.

Eight months into my first pregnancy, an 18-year-old Black man named Michael Brown was killed by police officers in Ferguson, Missouri. Michael Brown was not the first young Black man I’d learn about only in death, nor will he be the last. But as I stood on the cusp of motherhood, weeks away from giving birth to a baby boy, Michael Brown’s death hit close to home. I remember sitting on the kitchen floor, weeping at the thought of raising my son in a country where Black boys were subject to death for acting like normal teenagers.

Our baby was coming, and crying would not change the unjust world he was being born into. I knew I had to do something, and that even small drops could make big ripples. So I threw myself into local civic causes. I had always voted, but now I wanted to make sure people who looked like me and experienced the injustices I did had a voice at the polls. I called voters, wrote letters to elected officials, and worked at polling places. In between my shifts as a nurse practitioner, I organized blood pressure check events with voter registration opportunities. I brought voter […]

Guest Author2022-10-04T10:04:03-04:00October 4th, 2022|health care policy, Public health|1 Comment

Sickle Cell Disease in Children and Adolescents: Aligning Practice with Guidelines

CDC report points to areas for improvement.

The Morbidity and Mortality Weekly Report (MMWR) released by the Centers for Disease Control and Prevention on September 20, 2022, highlights an important opportunity for nurses to provide evidence-based care to children with sickle cell disease (SCD). The report highlights poor compliance with guidelines recommending that children ages 2 to 16 with sickle cell anemia (SCA)—the most common and often most clinically severe form of the disease—should receive transcranial Doppler (TCD) ultrasound screening and that hydroxyurea (HU) should be offered for all children with SCA ages 9 months and older.

In the past, children with SCD usually did not survive past age 20 because of infections/sepsis and stroke. Children with SCD now can live much longer, into their 40s, 50s, and 60s, as a result of the use of penicillin to prevent sepsis and screening for children at high risk for stroke. According to current guidelines for children and adolescents with SCA, when children are screened for stroke by TCD, those at high risk can be identified and referred for monthly transfusions, a practice that has been found to prevent stroke. In addition, there is much evidence supporting the use of HU, including prevention of severe pain episodes, acute chest syndrome, and hospitalization.

Guest Author2022-09-29T10:59:11-04:00September 29th, 2022|Nursing|0 Comments

October Issue: Substance Use Among Nurses, RN Involvement in Staffing Policymaking, More

“Under my leadership—like that of the editors before me—these pages will serve to document and transform clinical practice and provide a space for nurses to contribute their voices to matters affecting our world today.”—AJN editor-in-chief Carl Kirton in this month’s editorial

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

CE: The Impaired Nurse

A guide to early recognition, diagnosis, and treatment of substance-related disorders among colleagues in the workplace.

Original Research: ‘It Would Be Nice to Think We Could Have a Voice’: Exploring RN Involvement in Hospital Staffing Policymaking

This qualitative study examined staff nurses’ perceptions of factors that hinder or support nurse involvement in hospital nurse staffing policymaking—and how nurses are, or would like to be, so involved.

Historical Feature: A Long History of Abortion

In response to the Supreme Court’s decision ending the nationwide right to abortion, the author takes a close look at abortion in American history and AJN’s archives, including the various roles played and challenges encountered by nurses.

[…]

Diane Szulecki, editor2022-09-26T08:56:14-04:00September 26th, 2022|Nursing|0 Comments

In the Nick of Time: Advance Care Planning in the ICU

Marian Grant, palliative care NP

I’m a health policy consultant for national palliative care organizations and often advocate for advance care planning, a process that helps people with serious illness prepare for future decision-making. I also work as a palliative care nurse practitioner (NP) in an academic medical center where I see the real-life aspects of advance care planning.

I recently saw a patient whose case typifies how advance care planning and policies to support it can work. A middle-aged woman with metastatic breast cancer at our cancer center had been seen the day before by the palliative care NP there. The NP was called to help assess the patient’s new-onset dizziness. While seeing the patient, she also spoke to her about her cancer status and suggested completing an advance directive. According to the NP’s note, the patient’s son, who was there with her, seemed surprised that things were not going as well for his mother as they had hoped.

The ‘Five Wishes’ advance directive.

Later in that same visit, the patient became profoundly hypotensive and was sent to the emergency department and then admitted to the medical ICU. The team there put in a request for a palliative care consult for metastatic cancer. I first saw the patient the next morning. […]

Guest Author2022-09-22T10:08:13-04:00September 22nd, 2022|end of life, Nursing, Palliative care|1 Comment

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The news hits close to home for a mother-to-be.

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CDC report points to areas for improvement.

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The ‘Five Wishes’ advance directive.

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