Heat Illnesses: Nursing Essentials from a NYC Emergency Department

As complex as health care may be in an emergency department (ED) setting, the weather and seasonality have added additional variables to that complexity. It is critical that registered nurses in the ED understand the health care trends associated with the weather and seasons. As in many other places, the summer here in New York City is a time when people are more active, spending time outdoors and traveling. This summer we have experienced several stretches with temperature in the high 90 degrees. July recently had a seven-day stretch with temperatures nearing and exceeding 100 degrees in New York. These heat waves can become physiologically unbearable.

Jonathan Nover, MBA, RN

Who is most vulnerable to heat illness?

During these heat waves, it is important to recognize the pockets of vulnerability among us. Older adults are often the most vulnerable because of decreased capacity to thermoregulate in response to changes in temperature. It is also important to consider the effects of heat on the homeless community and people without access to air-conditioned environments. Children are more susceptible to heat illness than adults. Some medications, such as diuretics, and consumption of alcohol and illicit drugs can increase a person’s risk of heat exhaustion. Additionally, individuals who perform strenuous […]

The Monkeypox Vaccine: What Nurses Need to Know

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell, cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

In the current monkeypox outbreak, the pandemic-strained U.S. public health system is once again faced with a major threat. This time, a vaccine is already available, but only in limited quantities. Here’s what nurses need to know. It will remain important to keep up with new developments as they occur.

The Jynneos vaccine

Jynneos is a live but nonreplicating vaccine for the prevention of both monkeypox and smallpox. It is made from vaccinia virus, a less virulent relative of these two viruses. The vaccine is given subcutaneously in two separate doses administered at least 28 days apart, and a person is considered fully vaccinated two weeks after the second dose.

The most common vaccine side effects are pain, redness, induration, swelling, or itching at the vaccination site. (People with HIV infection or atopic dermatitis do not seem to experience additional or more severe side […]

Rotating Night Shifts Erode Long-Term Health of Nurses

Ten years or more of such shift work decreased the odds of healthy aging by 20%.

Shift work is a staple of hospital nursing, and several large studies have found that rotating night shifts, in particular, are associated with increased mortality. Now, an international group of researchers has found evidence of significant harm to nurses’ overall health from rotating night shifts.

Detrimental effects on healthy aging.

Published in the May issue of JAMA Network Open, the study by Shi and colleagues found that 10 or more years of night shift work—defined as at least three nights per month in addition to day and evening shifts—conferred 20% decreased odds of healthy aging. The study’s end point for healthy aging was reaching age 70 without major chronic disease, physical limitations, memory impairment, and mental health issues. The association between a history of night shift work and deteriorated health was unchanged when age, body mass index, or lifestyle factors were considered. Although the mechanisms underlying these effects are unknown, the authors pointed to several possibilities, including altered circadian rhythms since they are important to metabolic regulation and disruptions may impair physical health.

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2022-08-04T09:23:34-04:00August 4th, 2022|Nursing|0 Comments

Monkeypox Update: As Knowledge Increases, More to Be Learned

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell (blue), cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

It seems impossible that we have to confront the rapid spread of a new virus when we’re still dealing with the effects of COVID-19. But for monkeypox, we didn’t have to respond “from scratch.” After decades of research and clinical work on smallpox, a related but considerably more lethal virus, testing protocols and vaccines were already available for use in monkeypox.

Nearly 20,000 cases of monkeypox have been reported around the world since May, with more than 5,000 infections reported in the U.S. There are probably many more undiagnosed and unreported cases.

Variations in presentation.

In New York City, where more than 1,000 cases of monkeypox have been reported, clinicians are seeing variations from “classic” presentations of monkeypox. The NYC Department of Health and Mental Hygiene reports that many people with monkeypox are not experiencing prodromal symptoms […]

Not to Save the World, But to Care, One Life at a Time

A nurse ponders the question of what makes her work matter.

Illustration by Janet Hamlin for AJN.

The Reflections column in AJN‘s August issue, “To Care When There Isn’t Enough,” is by Alison Stoltzfus, an obstetrics nurse at Evangelical Community Hospital in Lewisburg, PA. Stoltzfus describes her experience volunteering as a nurse at a medical clinic in the world’s largest refugee camp, the Rohingya refugee camp in Ukhiya, Bangladesh.

The work could be overwhelming at times. The camp she describes is a place where human illness and suffering often far exceed the capacities of available medical resources. She writes:

Some days the people would throng me in triage, pulling on my clothes and begging to be seen, desperation and longing in their eyes. A longing that at times I had to refuse.

Every day I would ask myself—“How can one care in a setting like this, and make a difference?” What good was it to make a difference to a few when there were so many lives I could not touch and so many problems we could not heal?

One life at a time.

The story centers around the author’s efforts to use the minimal medical equipment available to help […]

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