Caring for Patients Who Have Bariatric Surgery

Roux-en-Y gastric bypass. Image courtesy of Ethicon Endo-Surgery, Inc.

By Sylvia Foley, AJN senior editor

People who are obese (BMI of 30 kg/m2 or greater) are prone to a laundry list of ills. They’re not only at greater risk for diseases such as type 2 diabetes, coronary heart disease, stroke, and osteoarthritis—they’re also more apt to experience discrimination and psychological abuse, and to suffer from anxiety and depression. Many have repeatedly tried to lose weight through diet, exercise, psychotherapy, and pharmacotherapy, to no avail. Until recently, there was little else providers could offer them.

But bariatric surgery, known to be an effective treatment for obesity and obesity-related comorbidities, is becoming an increasingly common option. In 1998, only about 13,000 bariatric procedures were performed in the United States; by 2007 that figure had jumped to 200,000, and it continues to rise. With prevalence rates for overweight and obesity also at record highs in this country, more nurses will likely find themselves caring for patients who have undergone such procedures.

In this month’s CE, “Outcomes and Complications after Bariatric Surgery,” authors Lauren Gagnon and Emily Karwacki Sheff explain the two main types of bariatric surgery and outline five of the most common procedures in the United States: 

2017-07-27T14:52:43-04:00August 30th, 2012|Nursing|1 Comment
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Domestic Violence Screening: Why the Rush to Dismiss It?

Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

All rights reserved. Photos by author.

A recent study reported in JAMA, “The Effect of Screening for Partner Violence on Women’s Quality of Life” (abstract only), is being touted in overly simplistic headlines across the Web (the word “debunks” has been getting a lot of use) as further evidence that domestic violence screening doesn’t improve outcomes for women.

Don’t believe it.

The problem doesn’t lie with the researchers or with JAMA; they accurately reported just what they found. The problem lies with how it is being interpreted by others as further proof of the overall ineffectiveness of screening for intimate partner violence (IPV).

What the study actually found was that there was no difference in health outcomes between women who received computerized screening and a resource list and women who just received the resource list or women who received neither.

This is how it worked:

Women in primary care settings who agreed to participate and who were randomized to the screening group were seated in front of a computer and responded to the three questions in the partner violence screening (for example, “have you ever been hit, kicked, punched or otherwise hurt by someone within the past year?”) on […]

2016-11-21T13:09:26-05:00August 24th, 2012|Nursing|1 Comment
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What’s New on the Nursing Blogs?

By Jacob Molyneux, AJN senior editor/blog editor

Matthew Bowden/Wikimedia Commons

So what’s new on the nursing blogs. I’ve been checking around today, and here are a few good things I’ve found so far. Please let me know if there are any really new and lively nursing blogs we should add to our nursing blogs page. We need some new voices, and I’m sure they’re out there.

Burnout. At Nursing in Hawaii (this blog changes its name periodically to reflect the current location of its peripatetic owner), we find a pretty interesting and roundabout kind of post, “Nurse Burnout, Reality Shock, Marlene Kramer,” that addresses the stages of nurse burnout in a really useful and practical way (after discussing an early seminal book on the topic, what this has to do with the development of the Magnet program, and a few other items). Here’s an excerpt, but I’d suggest reading the whole thing for a look at this seemingly universal issue for nurses.

the honeymoon. This is where the new nurse is still being oriented and everything is wonderful. The preceptor is so smart! The staff is amazing! The paycheck is HUGE! we all love to be around such a person and delight in the innocence of youth.

crash and burn. the onset of this is hard to predict, but usually about the six-month mark. Takes place when the nurse starts getting feedback from every direction, not […]

2016-11-21T13:09:27-05:00August 22nd, 2012|nursing perspective|2 Comments
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Health information Technology, EHRs, Meaningful Use, and Nursing

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

If you’re like most nurses working in a health care organization, you’ve been involved in a migration to electronic health records, computerized physician order entry (CPOE), or bar code medication administration.

If you’re lucky, nursing input was considered during the planning stages of all this health information technology (HIT). We’ve heard from many nurses (and have had a few submissions from nurses about their experiences—see for example the Reflections essay “Paper Chart Nurse”) who have had “issues” with the systems or who wonder, why the big push?

In the August issue of AJN, which is available online and on the iPad (download the app here), Susan McBride and colleagues John Delaney and Mari Tietze debut their three-part series on HIT. The first article, “Health Information Technology and Nursing,” examines the federal policies behind efforts to expand the use of this technology, the importance of meaningful use, and the implications for nurses. Subsequent articles upcoming in the fall will take a closer look at the use of HIT to improve patient safety and quality of care, and the important role nurses are playing—and could play—in this system-wide initiative.

It’s crucial for nurses to understand HIT. As the authors note,

“If HIT systems are going to truly improve care, nurses need a voice in their planning and development to ensure patient safety and system usability. The success of this technology depends on nurses informing the […]

2016-11-21T13:09:28-05:00August 15th, 2012|digital health, nursing perspective|3 Comments
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A Slyly Witty Essay on an Apparently Aphasic Patient, Plus a Plug for Submissions

By Jacob Molyneux, senior editor/blog editor

I edit many types of articles, but one certainty each month is that I’ll be editing our Reflections essay. This month’s is by Kathryn Mason, MSN, RN, PCCN, formerly a clinical educator and now a QM/PI project manager at the same hospital. Called “A Man of Few Words,” the essay is about that patient who is hard to connect with because she or he can’t (or won’t) speak. The piece has a surprising ending. Here’s an excerpt from the opening paragraphs, but please click the title above and read the whole short essay.

The nursing care plan called for dressing changes to the foot four to five times per week. I made at least three of those visits each week and my routine with Willy became fairly rote. He sat in the same chair each time, with his foot propped on an ottoman; I was positioned in front of the foot, my back to his decrepit television. I would chatter away to compensate for his lack of dialogue, regaling him with stories of my children, the weather, or whatever other bits of news came to mind. Sometimes he would give me his rapt attention and at other times he would be more intent on the news or a game show. (To read more, click here.)

To submit an essay for consideration, please take two minutes to read the Reflections guidelines, a short Word file that describes what we are looking for and not looking […]

2016-11-21T13:09:29-05:00August 13th, 2012|nursing perspective|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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