Noise in the ICU: Terminology, Health Effects, Reduction Strategies, and What We Don’t Know

By Jacob Molyneux, AJN senior editor

Noise isolation headphones to use in loud environments via Wikimedia Commons

I woke up this morning, as I do every morning now, to the sound of pile driving at a large construction site a block and half away on the Gowanus Canal. It shakes the earth and reminds me of the forges of evil Sauron in one of the Lord of the Rings movies. I once had a dog lose a good bit of hair when there was a pile driver for several months in the lot behind another apartment in Brooklyn.

The negative physical and emotional effects of excessive noise get an occasional mention lately in health reporting, but in New York City or along the remotest forest lane, the forces of quiet can seem to be in rapid retreat before an army of leaf blowers, all-terrain vehicles, diabolically amped-up motorcycles, huge TV sets, garbage trucks, helicopters, and the like.

Lest I sound like a total crank (I do have useful noise-cancelling headphones plus an Android app that offers such choices as white noise, brown noise, burbling creek, steady rain, crickets, and soothing wave sounds), there’s a reason for the preamble. Florence Nightingale herself called unnecessary noise “the most cruel absence of care which can be inflicted either on sick or well,” as is pointed out by the University of Washington researchers who wrote the latest installment of our column Critical Analysis, Critical Care.

2016-11-21T13:04:45-05:00May 16th, 2014|nursing perspective, nursing research|0 Comments
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Remembering Nurses Who Go Above and Beyond as Volunteers

By Shawn Kennedy, AJN editor-in-chief

A severely dehydrated patient receives iv fluids from Kari Jones, MD, as she is carried by a family member from triage to a tent at the Bercy CTC. Photo courtesy of Samaritan’s Purse. A severely dehydrated patient receives IV fluids from Kari Jones, MD, as she is carried by a family member from triage to a tent at the Bercy CTC. Photo courtesy of Samaritan’s Purse.

So another Nurses Week winds down and many nurses have been acknowledged for the fine work they do. But I think more recognition should be given to nurses who go above and beyond their usual nursing work and volunteer to help those in dire circumstances. This month in AJN, one of the two CE articles is called “Responding to the Cholera Epidemic in Haiti.” It details the work of one organization and its nurses. Here’s the overview:

While Haiti was still recovering from the January 12, 2010, magnitude-7 earthquake, an outbreak of cholera spread throughout the nation, soon reaching epidemic proportions. Working through the faith-based nongovernmental organization Samaritan’s Purse, an NP, an epidemiologist, and a physician joined the effort to prevent the spread of disease and treat those affected. Here they describe the prevention and intervention campaigns their organization initiated, how they prepared for each, and the essential elements of their operations.

The article provides essential information about such topics as setting up cholera treatment centers, assessment, rehydration priorities, prevention, enlisting […]

2018-03-28T10:25:15-04:00May 14th, 2014|nursing perspective|1 Comment
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To Be a Nurse Is a Powerful Thing: Thoughts on Graduation

By Karen Roush, PhD, RN, FNP, AJN clinical managing editor

Photo by Karen Roush. Photo by Karen Roush.

After years of work and sacrifice, last month I successfully defended my dissertation. In the weeks leading up to my defense I found myself overcome with emotion each time I imagined that moment when I would hear myself called “doctor” for the first time. And my breath did catch in my throat when the questioning was over and the chair of my dissertation committee turned to me and said those magic words, “Congratulations Dr. Roush.”

But then something funny happened. There was no incredible high. I wasn’t walking on air. For so many years I’ve been focused on the goal of achieving a doctor of philosophy in nursing. But now that I’ve accomplished that, I am faced with a new and no less difficult challenge—what I do from here and how I make those words, Dr. Roush, mean something.

Many of you graduating this month may have similar feelings. It is a powerful thing to be a nurse. What we’ve learned in the classrooms, in hospital halls, in the connections that pass between us and our patients in moments great and small, has given us tremendous knowledge. But it is what we choose to do with that knowledge and how we do it that gives […]

2016-11-21T13:04:47-05:00May 12th, 2014|career, nursing perspective|1 Comment
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Intensive Care of a Different Ilk

MayReflectionsIllustrationThis month’s Reflections essay (“Intensive Care”) is by John Fiddler, an NP who describes his work as an inpatient hospice nurse in New York City as being “as close to the ideal of nursing as I have ever been.”

This is a big claim—but if you read Fiddler’s brief, artful summary of the evolution of his nursing career, which started in an actual ICU, and then his description of what he found when he went to work in a hospice, you might find that he makes a pretty good case.

Here’s a small excerpt:

Inpatient hospice to me was the room at the end of the palliative care corridor that I had never bothered to visit. I had pictured it as a quiet haven for the dying, where birds chirp outside and music is heard playing through open windows as patients calmly drift off and up into dusty shafts of sunlight.

Not quite.

Instead, picture a unit where patients arrive on stretchers in extreme pain and distress, afraid, breathless—usually with families trailing behind, holding on to as much emotional and personal baggage as they can carry. Often these patients bear the physical and psychic bruises of a prolonged ICU stay.

And this is what happens here…

Maybe the author will someday find another ideal of nursing care, or maybe he won’t, but it’s worth reading his account of the current one. Reflections essays are open access. (Click through to the PDF […]

2016-11-21T13:04:48-05:00May 9th, 2014|career, nursing perspective|1 Comment
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“One Day He Breaks Your Arm, and Then . . .”: How Nurses Can Help Rural Survivors of Intimate Partner Violence

Photo by Damien Gadal, via Flickr. Photo by Damien Gadal, via Flickr.

 By Sylvia Foley, AJN senior editor

“Imagine for a moment that your husband or boyfriend is regularly assaulting you, and often tells you that ‘nobody cares.’ Now imagine that you live in an isolated rural community. The nearest health care services are 75 miles away—and you can’t get there because he removes the car battery to keep you from driving . . . One day he breaks your arm, and then he drives you to that distant hospital. Will the nurses recognize what is happening? Will there be a chance for you to tell them?”

In this month’s CE feature, “Intimate Partner Violence in Rural U.S. Areas: What Every Nurse Should Know,” Amanda Dudgeon and Tracy Evanson explain why it’s important for nurses in all practice settings to understand the particular issues that rural survivors face and how to address them. (Most, though not all, victims of intimate partner violence are women; this article focuses primarily on female survivors.) Here’s a brief overview.

Intimate partner violence is a major health care issue, affecting nearly 6% of U.S. women annually. Multiple mental and physical health problems are associated with intimate partner violence, and billions of health care dollars are spent in trying to address the consequences. Although prevalence rates of intimate partner violence are roughly the same in rural and nonrural areas, rural survivors face distinct barriers in obtaining help and services. Because rural […]

2016-11-21T13:04:49-05:00May 7th, 2014|nursing perspective|4 Comments
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