Off the Charts

Losses: In Search of an Honest Prognosis

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Several years ago I took care of a lady who’d suffered a small cerebral hemorrhage after falling and hitting her head. She was in the ICU for several days. Her husband stayed at her side constantly, and he became a part of a never-ending loop in which she would wake up startled to be in a hospital, and then notice her husband and ask him where she was and what had happened. He’d hold her hand and gently relay the events of her injury, after which she’d react with mild surprise, every single time. Then she’d close her eyes and doze until she woke up to reinitiate the same conversation.

Her husband, after days of patiently playing his role in this repetitive scene, was clearly wearing down. He waited anxiously for the neurosurgeon, expecting explanations and hoping for reassurance.

When the neurosurgeon rounded later that day I heard him speak at great length about the details of her injury and the treatment plan. He ultimately advised that, although he thought she’d recover well, only time would tell.

Her husband wanted more than […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:10:27-05:00March 19th, 2012|patient engagement|1 Comment

The Affordable Care Act on Trial

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

According to the National Conference of State Legislatures, 47 states have enacted some legislation to block or limit various requirements of the Affordable Care Act (ACA). And a week from Monday, on March 26, the Supreme Court will begin hearings on the constitutionality of the law, as 26 states bring suit against the federal government. The primary issue for the Court: can the federal government mandate that individuals must purchase health insurance?

Other closely related issues the court has also set aside time to consider are whether other provisions of the law can still be implemented or must be voided if the individual mandate is struck down, the legality of the proposed Medicaid expansion, and whether the court must in fact wait until the individual mandate is actually implemented in 2015 before even considering its legality.

So how do many Americans feel? The Kaiser Family Foundation has been tracking opinions on the law and offers an excellent interactive chart that shows opinions according to different variables, including age, income, political party affiliation, gender, and current insurance status. Their findings may surprise you.

For more information about the Affordable Care Act and it implications for nursing, here are some links to AJN’s coverage since it was signed into law in 2010:

“Nurses and the Affordable Care Act,” Mary Wakefield
“What Future for the Affordable Care Act,” Diana Mason
“Health Care Reform and a System […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:10:29-05:00March 16th, 2012|health care policy|0 Comments

The Elusive Strict Diet

By Amy M. Collins, associate editor

Several days ago, we linked on our Facebook page to an abstract of a JAMA article that found that women hospitalized for myocardial infarction were more likely than men to present without chest pain. A few days later, my 59-year-old mother was told by her general practitioner that her ECG had shown an electric “blip” that could be due to scarring from an unnoticed heart attack. My mother—always too lax about these things (unlike her hypochondriac daughter)—calmly told me she always has random chest pains and it could have happened at any time.

A visit to the cardiologist a few days later eased our fears. She hadn’t had a heart attack, but was diagnosed with right bundle branch block and has to undergo further testing. With high C-reactive protein levels, elevated cholesterol, and a history of heart disease in the family, one can’t be too careful. A stress test and cardiac ultrasound have been ordered.

In discussing her cholesterol level, which had increased since my mother’s last wellness exam, the cardiologist suggested she start taking statins. Not keen on medication, and worried by recent reports of adverse effects from these drugs, she said she’d rather only start with that if there were no other options. His suggestion was […]

Amy M. Collins, managing editor2016-11-21T13:10:30-05:00March 14th, 2012|patient engagement, personal health practices, Public health|4 Comments

Kony 2012: A Real Villain, Plus a Few Questions

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

Social media is once again proving its power to engage people around the world—this time, in the efforts to find and capture Joseph Kony, the leader of the Lord’s Resistance Army (LRA), a brutal militia group that waged a war of terror in Uganda for two decades and is now operating, in a diminished but still lethal capacity, in the Central African Republic, the Democratic Republic of the Congo, and South Sudan.

Kony was indicted for war crimes by the International Criminal Court in 2005 based on his record of murder, torture, rape, and the enslavement of thousands of people, mostly women and children. At its height, his army was said to be comprised mostly of child soldiers—the children he abducted and forced to become killers, whose first victims were often their parents. Filmmakers with Invisible Children, a nonprofit organization dedicated to influencing change in Africa, created Kony 2012, a film that “went viral” last week and fuelled widespread support for a campaign to support efforts to capture Kony.

Kony and the atrocities of the LRA are not new “news.” AJN reported on the issue of child soldiers in Uganda and numerous other countries in 2005, when we profiled the work of nurses Susan McKay and Dyan Mazurana, […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:10:31-05:00March 12th, 2012|healthcare social media|0 Comments

‘Like an Origami Swan’ – Remembering Tea with Miss Elsie

“Hello,” I said. “I’m the nurse. I’m here to see Miss Elsie.”

“I know,” he answered, grabbing my wrist and pulling me inside.

The heat of the cramped house slammed into my face. The windows were closed and the shades pulled down. Without a word, my little escort guided me down a narrow hallway into a room not much bigger than a closet, then deftly released my wrist and slipped out of sight.

So starts “Tea With Miss Elsie,” by Claire Schuster, MSN, RN, APRN-BC, CWS, associate professor emerita in the nursing program at Berea College, Berea, Kentucky. The Reflections essay in the March issue of AJN is a subtle, quiet portrait of a moment and the gesture at its heart, and it’s well worth a read. (For the most appealing version, click through to the PDF version link in the upper right of the landing page.)—JM, senior editor