Off the Charts

The Patient With No Name: When Nursing Illuminates Literature

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN. She doesn’t usually write about books in her posts, so we hope you enjoy this change of pace.

I didn’t know much about The English Patient when I picked it up recently at a library book sale—I only dimly recalled that the novel had been made into a movie I’d never seen. Since it was published by Michael Ondaatje in 1993, I can hardly blame a lack of time for my lapse. Yet I found myself glad I hadn’t read it until now, as my own nursing experiences suffused my reading of it, leaving me more deeply moved than I might have been otherwise.

The novel is set in the final days of World War II, in a bombed Italian villa that had served as a war hospital. As the story opens, the makeshift hospital has been recently evacuated, with patients and medical staff relocating to Pisa. One nurse remains, though—a young Canadian named Hana. Described as “shell-shocked” due to her experiences during the war, she refuses to leave the damaged hospital or a nameless English patient, who she insists is too fragile to be moved.

Other characters come into […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:08:53-05:00November 16th, 2012|nursing perspective, patient experience, Patients|4 Comments

Appreciating War-Time Nurses the World Over

Peggy McDaniel, BSN, RN, an occasional contributor to this blog, works as a clinical liaison support manager of infusion, and is currently based in Brisbane, Australia.

Vivian Bullwinkel / Wikipedia

“Chins up, girls. I’m proud of you and I love you all.”

According to a survivor’s account, these words were spoken by an Australian nurse, Irene Drummond, on Radji Beach, February 16, 1942. This crescent-shaped stretch of white sand is in the Banka Strait near Banka Island, Indonesia. Ms. Drummond and 21 fellow Australian nurses (plus one civilian) walked into the warm sea holding hands, creating a human chain. As their feet touched the surf they were riddled with bullets from Japanese machine guns set up on the beach behind them.

The Banka Strait was an escape route from Singapore and the larger region just before and during the Japanese occupation of Singapore during World War II. The Aussie nurses, some of the very last military personnel to be evacuated from Singapore before the occupation, had snuck away under at night aboard the Vyner Brook in February 1942. They were among approximately 200 passengers attempting to escape to safer ground, but Japanese pilots bombed and sunk the ship. Civilians, military personnel, and nurses died during the attack on the Vyner Brooke, and many of the same escaped into lifeboats. Some of the survivors made it to the shore and ultimately ended up on Radji Beach.

As an American nurse living and working in Australia […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:08:54-05:00November 14th, 2012|Nursing, nursing history|9 Comments

Veterans, Nurses, and PTSD

By Maureen Shawn Kennedy, AJN editor-in-chief

Vietnam Women’s Memorial, Washington, DC. Courtesy of Kay Schwebke.

Veteran’s Day was officially yesterday, November 11, but many will mark it today with a day off from work and school and for some reason, shopping. I’m not sure when or why Veterans Day became associated with bargains, but it seems especially out of place this year, as we hear more and more about the issues being faced by the thousands of new veterans. As I note in my November editorial, an Institute of Medicine report estimates that 13% to 20% of returning veterans from Iraq and Afghanistan “have or may develop PTSD.”

Last month, I had the opportunity to spend some time with Brigadier General (Ret.) Bill Bester, former chief of the Army Nurse Corps. I interviewed General Bester about his career and veterans’ health issues. The general was engaging and candid about the difficulties returning veterans face and he spoke about the post-deployment transition period that can be difficult for returning veterans.

He also spoke about his current activities as a senior advisor for the Jonas Foundation’s Veterans Healthcare Program, which supports scholarships for nurses pursuing doctoral degrees related to veteran-specific health issues. The program supports nurses pursuing both PhD as well as DNP degrees and hopes to focus on researching the issues as well as implementing best practices.

With many veterans accessing care outside the VA system, it’s important for nurses in all […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:08:55-05:00November 12th, 2012|Nursing|0 Comments

Behind Our Ambivalence About Flu Vaccines

By Amy M. Collins, editor

Influenza virus particle/CDC

Tis the season to start thinking about getting the flu vaccination. Every year I consider doing so, but due to my own personal vaccine angst I usually decide to just take my chances (while simultaneously lecturing elderly family members to make sure they get theirs, of course). Working in Manhattan, with the vaccine available at most pharmacies and even vaccine access through work, gives me very little reason to forgo vaccination. And my theory that I am young and strong and can brave illness gets weaker as I pass the point of being able to comfortably claim youth. Riding the subway every day amid a festival of germs reminds me that I should know better.

The vaccine has caused a stir over the past few years: during the 2009 H1N1 pandemic, people worried about whether or not to get the new combined vaccine, and the question of mandatory vaccination for health care workers remains a hot topic even now.

But a new report, The Compelling Need For Game-Changing Influenza Vaccines, released by scientists at the Center for Infectious Disease Research and Policy at the University of Minnesota, suggests that the flu vaccine may not be as effective as it is touted to be. According to the report, influenza vaccinations provide only modest protection for healthy young and middle-aged adults, and little if any protection for those 65 and older—those who are […]

Amy M. Collins, managing editor2016-11-21T13:08:55-05:00November 9th, 2012|Nursing|3 Comments

Depression in Older Adults: A Nurse’s Guide

By Sylvia Foley, AJN senior editor

‘Mourning Old Man’ by Vincent Van Gogh

“It is a misconception that depression is a normal, inevitable part of aging; it is not,” writes author Cynthia Cahoon in this month’s CE, “Depression in Older Adults.” Depression affects an estimated 15% to 19% of Americans ages 65 and older living in a variety of settings, yet it often goes unrecognized and untreated. Granted, recognition can be challenging, in part because many symptoms of depression are also common to other illnesses seen in older adults. As Cahoon points out, though, there is also “abundant evidence that depression in older adults is treatable, perhaps in as high as 65% to 75% of cases.”

The article provides an overview of depression in older adults and outlines its pathophysiology and disease types. Known risk factors for this population include the following:

chronic medical conditions
polypharmacy
multiple losses
functional decline (physical, cognitive, or both)
personal or family history of depression
social isolation
substance abuse or dependence

According to Cahoon, a majority of adults with depression will present for treatment of physical conditions, rather than for a mood disorder. So it’s important to assess each patient’s mood, regardless of presenting symptoms. Several brief, validated screening tools exist, and busy nurses have several options. One tool, the Whooley Depression Screen, takes less than five minutes to administer and asks just two questions: