Mental Illness and Public Tragedy: Recognizing Critical Warning Signs

In 2020, I was asked to review a submission for AJN’s Viewpoint column. Reviewers are not told who the author of a work is, nor are authors informed who is reviewing their submission. But I hadn’t gone very far when I knew exactly who the author was and what she was writing about.

Photo © Shutterstock

In my career I have read and been moved by many articles and first-person accounts, but this time was different. Each word took me closer into what I realized was a very personal viewpoint on an unimaginable national tragedy.

The author of the article was Arlene Holmes, a nurse and mother who was writing about her son James, who on July 20, 2012, opened fire on movie theater patrons in Aurora, Colorado, killing 12 and wounding 70. (Her article, “Why a Nurse (and Mother) Didn’t Know,” was eventually accepted and published in AJN‘s June 2020 issue.)

Asking the same questions over and over.

After completing the review of this article, the questions I asked myself were the same ones I ask each time we hear of such tragic events happening at the hands of someone who has a mental illness:

What could have been done to change the outcome and […]

2021-09-16T10:05:00-04:00September 16th, 2021|Nursing|0 Comments
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Delta, Mu, and Others: What to Know About Covid Variants

Daily Trends in COVID-19 Cases in the U.S. Reported to CDC (9-21-21): red line shows 7-day moving average. Click image to enlarge.

According to the CDC, the delta variant now makes up more than 99% of COVID-19 cases across the U.S. Recently, though, the media has been drawing attention to the mu variant. Should we worry?

How serious are variants?

Viruses constantly change. Mutations might make a virus easier to spread or more virulent, change its clinical presentation, or alter its response to tests, vaccines, or treatment. Or there may be no observable change in its characteristics at all. Some variants simply fade away; others stick around, but can’t compete with more dominant variants and never really get a “foothold” in a particular population. At this time—and this is a pretty big caveat—the COVID-19 mu variant seems stuck in this last category, at least in the U.S.

What about mu?

Although the mu variant has been identified in more than 39 countries, including the U.S., there have been only about 2,000 cases here, mostly in California, Florida, Texas, and New York. The World Health Organization (WHO) calls mu a “variant of interest” […]

2021-09-14T14:36:42-04:00September 14th, 2021|COVID-19, infectious diseases, Nursing|1 Comment
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Acute Care Nurses: An Endangered Species?

Our acute care settings are in crisis—staff are physically and emotionally exhausted. And many have decided they can’t take it anymore.

“At the virtual conference of the American Organization for Nursing Leadership (AONL) in July, researcher Peter Buerhaus reported preliminary findings of his study on the impact of the pandemic on the nursing workforce. He reported that a phone survey of over 800 AONL members conducted in May revealed that more than 50% of hospital chief nurse officers were seeing “increased retirements, sick leave, and early exits, including among younger nurses.”— AJN Editorial, September 2021

It’s been no secret that the hospital work environment has been problematic for nurses and patients alike—we know stressed and worn-out clinicians make more errors, and patient care suffers. In 2004, the Institute of Medicine released Keeping Patients Safe: Transforming the Work Environment of Nurses, which discussed workplace staffing and processes as intrinsic to ensuring patient safety. More recently, the National Academy of Medicine published Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being (2019), which noted, “The job demands placed on clinicians are often greater than the job resources available to them; this imbalance can lead to burnout.”

2021-09-10T08:59:51-04:00September 9th, 2021|Nursing|0 Comments
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The Power of Pictures in Therapeutic Healing

Sam was a 17-year-old who had been admitted following a major traumatic leg injury. The surgical teams were trying to save his leg.

A colleague asked me to ”pop in” on him, since he was having a hard time coping. Frankly, he was completely bummed out.

Sam and his mom were together in his room waiting to go to OR. I introduced myself as a nurse working with the pain management/spiritual care team. Conversation was stiff but polite. Sam made no eye contact with me at all.

Building relationships takes time.

photo courtesy of author

Following his procedure, I made a point of stopping by to visit almost every day. Mom had warmed up to me—Sam just a bit. It was an isolating time in the hospital. Visitors were not allowed, except for a single family member for pediatric patients, and the contacts with staff were often task focused and purposeful. One afternoon, I saw mom sitting in the hallway talking on her cell phone, crying. So I waited.

When she ended her call, I asked if she’d like some company. Our conversation found its way from the hospital to the kitchen, stopping along the way as we shared family and shopping tidbits. She laughed and we connected. I also learned a […]

2021-09-07T08:34:46-04:00September 7th, 2021|nursing perspective, nursing students, patient engagement|0 Comments
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Children’s Mental Health Crisis Reveals Holes in System

You don’t have to look far for evidence that the mental health of children and adolescents has been entering a crisis in recent years, one exacerbated by the unusual conditions imposed by Covid-19.

The June 18 Morbidity and Mortality Weekly Report (MMWR) from the CDC reported:

During February 21–March 20, 2021, suspected suicide attempt ED visits were 50.6% higher among girls aged 12–17 years than during the same period in 2019; among boys aged 12–17 years, suspected suicide attempt ED visits increased 3.7%.

Photo by Yasser Chalid/Getty Images

As noted in a recent Washington Post story, “Emergency departments have meanwhile become a tattered safety net for adolescent mental health care.”

In this month’s AJN, Betsy Todd summarizes some of the current issues seen by school nurses and other health care professionals like nurse practitioners (NPs), who often feel overwhelmed by the intensity of the suffering and need they are now seeing in many children.

Systems pushed to their limits.

Todd notes that existing systems are proving woefully inadequate to the growing need, with wait times increasing to see child psychiatrists, therapists, and other experts, and pediatric hospitals in several states reporting “sharp increases in ED visits for anxiety, depression, […]

2021-09-03T12:37:10-04:00September 3rd, 2021|mental illness, Nursing, pediatrics|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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