When a Person with Type 1 Diabetes Goes to the Hospital

Photo by Susan Q Yin on Unsplash

I have always done everything I can to avoid hospitalization. Aside from concern about potential surprise bills, it’s a control thing: I’ve simply been afraid of turning over care of my blood glucose levels to anyone else. I’ve had numerous outpatient surgeries and procedures, but for the nearly three decades since I was diagnosed with type 1 diabetes in my mid-20s, I never spent a night in a hospital.

In retrospect, the one time I should have accepted hospital admission was immediately following the shock of the diagnosis, which followed close on several months of unexplained weight loss, increasingly unbearable thirst, blurring vision, and general disorientation. My blood glucose level had been off the charts, plus I needed time to reckon with the loss of freedom for my always more or less healthy and fit body and to begin to learn to balance insulin shots, glucose levels, food intake, physical activity, and much else. But I was in denial (with predictable consequences) for quite some time afterward, and had also turned down the cost of health insurance when entering graduate school.

In the hospital.

In any case, one frigid, iced-over night this early January, I […]

2022-06-07T09:32:16-04:00June 7th, 2022|Nursing, patient experience, Patients|2 Comments
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Monkeypox: The Basics for Nurses

In the past, cases of monkeypox only occasionally occurred outside of central and western Africa, where the disease is endemic, and it was virtually always related to travel or to the inappropriate relocation of wild animals. (In the US in 2003, 71 cases of monkeypox in six states were traced to pet prairie dogs that had been imported in the “exotic animals” trade.) What should we make of the outbreaks this year in 23 countries where the disease is rarely seen?

Current cases of monkeypox are occurring in people without a history of travel to endemic areas, and in some cases without obvious contact to known cases. Most of these people have had mild disease, though monkeypox can cause severe disease in young children, pregnant women, and immunosuppressed individuals. While monkeypox usually is not highly transmissible nor deadly, it has never spread to so many countries seemingly simultaneously.

A close relative of smallpox.

Monkeypox is a close relative of smallpox, and the smallpox vaccine also prevents monkeypox infection.  Many experts point to the end of mass smallpox vaccination campaigns as a factor in the emergence of cases at this time. Forty years ago, about 80% of the population was vaccinated against smallpox; today that figure is only about 30%. Monkeypox cases have been on the rise since smallpox was declared to be eradicated in 1980. In one monkeypox-endemic region, cases had increased twentyfold in recent decades. At the same […]

2022-06-02T10:14:45-04:00June 2nd, 2022|infectious diseases, Public health|1 Comment
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June Issue: Cardiac Devices for Heart Failure, Using EHR Data for Research and QI, More

“When nurses practice real self-care, they come to a place of self-respect, learn to hear their own voice, and recognize when their expressed needs are ignored. “—Emily Stice Laker in her Viewpoint article, “Nurses Need More Than Self-Care”

The June issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

CE: Guideline-Directed Cardiac Devices for Patients with Heart Failure

The author reviews current device therapies for heart failure and uses a composite case to demonstrate how bedside nurses can help patients understand treatment options, potential complications of implantation, and post-op care.

Special Feature: Assessing EHR Data for Use in Clinical Improvement and Research

This article introduces nurses to the secondary analysis of EHR data, first outlining the steps in data acquisition and then describing a theory-based process for evaluating data quality and cleaning the data.

Nursing Research, Step by Step: Diagnostic Studies: Measures of Accuracy in Nursing Research

This article, one in a series on clinical research by nurses, reviews the use of diagnostic and screening tests and tools in nursing research and clinical practice.

[…]

2022-05-31T09:08:10-04:00May 31st, 2022|Nursing|0 Comments
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What Will It Take? When Will We Act?

Once again, we are sickened by another school shooting and the loss of children and teachers who tried to protect them from being mowed down by an assault weapon in the hands of an 18-year-old boy. This time Uvalde, Texas, is grieving for 19 children and two teachers, and it’s less than two weeks since a shooting in a Buffalo grocery store left 10 dead. Of course, we immediately see the messages from legislators offering their condolences and thoughts and prayers, but no promises to change anything. If not them, then who can?

I remember the awfulness of treating the occasional pediatric gunshot victim when I worked in the ER—usually an unintended target who was caught in crossfire. It was gut-wrenching, the kind of thing that should be a “never-event.” Today, ER nurses, paramedics, and physicians see young gunshot victims far too often. I don’t know how they can do it day after day, trying to comfort parents while dealing with their own trauma.

The leading cause of mortality in children and adolescents.

Firearm deaths are now the leading cause of mortality in children and adolescents (ages 1 to 19 years) in this country, according to a recent analysis by researchers at the University of Michigan reported in the New England Journal of Medicine. How […]

2022-05-27T14:01:41-04:00May 27th, 2022|gun violence, pediatrics, Public health|3 Comments
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Nursing Conferences: A Vital Part of Professional Development

On missing nursing conferences during the pandemic.

Almost each year since it began, I would fly to wherever the American Association of Critical-Care Nurses (AACN) was holding its annual National Teaching Institute (NTI). At first, I attended because I was a critical care nurse, working in the emergency shock trauma area of New York City’s Bellevue Hospital, and found the content invaluable. I had also joined the local chapter and knew others going to the meeting. I remember my first NTI in New Orleans—so many sessions, and meeting other nurses from around the country who were doing such amazing work gave me a sense of pride in my profession.

As my career progressed and I moved away from direct patient care into staff development, I would still attend to keep up with new information that I needed to incorporate into educational offerings. When I began working with AJN, first in CE and then as news director, I still attended to keep up to date and to network.

The COVID-19 pandemic interrupted life and conferences—while virtual conferences at least offered content updates, they lacked the opportunity for personal networking that I find so important. This year there was an in-person NTI, but I opted not to attend because of the highly contagious COVID-19 variants in circulation.

But what I did do was what something that has become an AJN-AACN tradition—I interviewed the outgoing president […]

2022-05-25T07:40:06-04:00May 24th, 2022|Nursing|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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