Off the Charts

Fear of Violence: A Poor Rationale for Better Mental Health Care

Insulin shock therapy is given in Lapinlahti Hospital, Helsinki in 1950s (Wikimedia)

By Doug Olsen, PhD, RN, associate professor, Michigan State University College of Nursing, and AJN contributing editor. Olsen regularly addresses topics related to nursing ethics.

There are many good reasons to provide better mental health care in the United States; however, the prevention of mass murder is not one of them.

Mental disorders involve great suffering, and many people who could find some relief through treatment either don’t receive it in a timely fashion or never receive it at all. After the large psychiatric hospitals of the mid-20th century discharged their patients in waves of deinstitutionalization starting in the 1970s, many of the resources that were promised to support these people in the community never materialized. In recent decades, many persons with mental disorder have ended up in the prison system, often for minor offenses, where treatment, if received at all, can be harsh and inadequate. (See: Early, P. (2006). Crazy: A Father’s Search Through America’s Mental Health Madness). A

Adequate resources to support all persons with serious and persistent mental illness in the community would prevent and alleviate a tremendous […]

Guest Author2016-11-21T13:08:34-05:00January 11th, 2013|Ethics, Nursing, Patients, safe staffing|1 Comment

The Depression Project

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May (2012 issue) of AJN. She currently has an essay appearing in The Examined Life Journal.

Wikimedia Commons

Lately, as a long-time runner, I can’t help but draw parallels between working on a nursing research project and training for a distance race set far in the future. Especially in the middle of a long run, when frazzled edges smooth out and clarity settles over me, the similarities between the two are striking. Both require inspiration and a goal, fluid planning and accommodation for the unexpected, and patience.

I casually refer to the nursing research project I’m involved in as “The Depression Project.” It was borne of concern among the ICU nurses about the mental states of the trauma patients in our unit. As the bedside care providers, we often come to know our patients very well; we don’t just care for these people, we sincerely care, and so we’re troubled when we observe, time and again, trauma patients who seem to lose the motivation to engage in their recoveries. They become flat and despondent; they lose hope.

It’s clear to the nurses that while the physical injuries sustained present enormous challenges, the emotional toll is sometimes just as debilitating—yet underestimated. And so we devised a study to illustrate the correlation of depression and recovery.

It’s […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:08:35-05:00January 9th, 2013|career, Nursing, nursing research, patient experience, Patients|4 Comments

Why Aren’t There More Men in Nursing?

Male nurse action figure/ gcfairch, flickr

By Maureen Shawn Kennedy, MA, RN, AJN editor-in-chief

Men have served in nursing roles since at least the third century, when a special order of men was said to have existed to care for plague victims in Alexandria. And various religious orders seem to have had groups of men devoted to nursing tasks during the Middle Ages.

More recently, a number of men served as nurses or in nursing roles during the U.S. Civil War—Walt Whitman, who extensively visited wounded soldiers during the Civil War, has sometimes been described as one, though he mostly focused on tasks like writing letters for illiterate soldiers, bringing them special foods and necessary items, and providing companionship. (See our article on Whitman from our 100th anniversary issue of October, 2000.)

There were schools of nursing for men since the early 1900s. Last year, we published “My Grandfather’s Unpublished Manuscript” (August, 2012), a wonderful story of how the author (a nurse) found an article describing her grandfather’s experiences during his education and nursing career, which began with graduation from nursing school in 1929.

There were several early articles about male nurses in AJN—the oldest one I found was from March, 1924: “A School of Nursing for Men,” by Kenneth T. Crummer, described the school of nursing for men at the Pennsylvania Hospital and its founding 10 years earlier, in 1914. The final sentence reads, “Who knows […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2016-11-21T13:08:36-05:00January 8th, 2013|career, nursing perspective|22 Comments

Health Technology Hazards: ECRI’s Top 10 for 2013

hazard/jasleen kaur, via Flickr

It’s a new year and with it comes new health care technology hazards to keep in mind, as listed in the most recent ECRI Institute report, 2013 Top 10 Heath Technology Hazards. While some risks from last year’s list made a repeat appearance, a few new topics made the cut for 2013.

Alarm hazards still posed the greatest risk, topping the list at number one. Other repeat hazards included medication administration errors while using smart pumps, unnecessary radiation exposure, and surgical fires. For an overview on these, see our post from last year.

Several new opportunities for harm seemed to involve new information technology (IT) that is making its way into health care facilities, such as smartphones and mobile devices. Here’s a snapshot of several of these, and some suggestions the report gives on how to prevent them.

Patient/data mismatches in electronic health records (EHRs) and other health IT systems

The risk: One patient’s records ending up in another patient’s file may not be a new phenomenon—it happened in traditional paper-based systems as well. But newer, more powerful health IT systems have the capability to transmit mistaken data to a variety of devices and systems, multiplying the adverse effects that could result from these errors.

Some suggestions: The report suggests that when purchasing health IT systems, facilities should consider how all the connected technologies facilitate placing the right patient data into the right record. […]

Amy M. Collins, managing editor2016-11-21T13:08:37-05:00January 4th, 2013|digital health, Nursing|1 Comment

Web Pickings: 2013 Predictions, Good Fat, Mammograms, Moderation, Nurse Wisdom, More

By Jacob Molyneux, senior editor

Cartoon showing baby representing New Year 1905 chasing old man 1904 into history/ Wikipedia

Ah, another new year starts (not 1905, despite the illustration) and received wisdom is overturned. Sort of. Consider the widely reported news that a JAMA study has found that being overweight doesn’t seem to increase your risk of dying, or, as the Kaiser Health News headline puts it, “A Little Extra Fat Could Be Protective.”

Many news summaries do point out that severely obese people had a higher risk of dying than did people of normal weight. What the study does and does not mean is being debated, with some pointing out that the study didn’t look at whether being overweight increased consumption of health care resources, number of prescribed medications, etc. We’re sure to hear more on this.

To continue with the theme of questioning long-term assumptions, NPR’s story “Breast Cancer: What We Learned in 2012” gives a nice summary of updated guidelines for who should and shouldn’t get mammograms, including pro and con arguments, the latest research, and so on.

Some pretty cynical journalism can be found in an opinion piece in the Palm Beach (Fl.) Post, which suggests that Hillary Clinton’s blood clot is a hoax.

A New York Times piece, in giving a tidy summary of important exercise-related research from the […]