Off the Charts

Improving the Response to Mental Health Emergencies

What is a mental health crisis?

Image by Petra Šolajová from Pixabay

As a psychiatric NP, I treat patients with mental illness through medication and therapy, but there are no guarantees treatment will work. It’s often a process to find a medication that both works to control the patient’s symptoms and doesn’t cause the unwanted side effects (such as sedation and weight gain) that can make a patient not want to continue taking it.

While this process is happening, the patient is living his or her life, coping with usual stressors such as working and navigating personal relationships, and possibly more intense stressors like poor living conditions or trauma. These factors can put someone at risk for a mental health crisis.

According to the National Alliance on Mental Illness (NAMI), “a mental health crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community.” When a person exhibits these types of behaviors, it’s common for 911 to be called and for police officers to arrive on the scene. This can have dangerous ramifications for the person with mental illness. However, […]

Guest Author2021-04-14T10:10:40-04:00April 14th, 2021|Nursing|0 Comments

Assessing the Post-Pandemic Future of Virtual Care

The following is a condensed version of an upcoming news article by Joan Zolot scheduled for AJN’s May edition.

Studies of safety and quality will determine the optimum use of this option.

Photo by Anna Shvets from Pexels

The use of telemedicine surged during the COVID-19 pandemic. Phone and videoconferencing limited patients’ exposure to the virus while maintaining their access to care. One estimate found that virtual care peaked at 42% of all ambulatory visits covered by commercial insurers in April 2020. The February 2 JAMA published several articles* addressing the safety, effectiveness, and quality of virtual consults and their future in health care.

Some obvious and potential benefits.

Because of its efficiency, virtual care has been shown to be particularly suitable for mental health consults, prescription refills, and straightforward evaluations. It can reduce patient inconveniences such as travel to appointments and lost work time. It can also enable patients to receive needed care sooner, especially those with limited mobility, caregiving responsibilities, or who live in remote areas. It may also have the potential to improve care coordination by enabling primary care clinicians and specialists to confer jointly with patients.

Risks, concerns, ongoing questions.

Because virtual medicine does not allow for physical examination, it’s inadequate for common clinical situations […]

Jacob Molyneux, senior editor/blog editor2021-04-07T14:15:14-04:00April 7th, 2021|digital health, patient engagement, Patients, Public health, Technology|0 Comments

Remembering the Polio Vaccine Rollout, Addressing Concerns Today

‘A Most Welcome Spring.’

That’s the title of the editorial in the recently published April issue of AJN. And if you receive the print issue or go to our Web site, www.ajnonline.com, I think you’ll see that our cover reflects an image that harkens to the end of a hard pandemic winter of isolation and—for many families—desolation. Spring has arrived, along with a feeling of hope that the vaccines will allow the world to open again, IF we can do so with caution and are successful in vaccine campaigns.

Remembering the relief at having a polio vaccine.

I was in kindergarten when Jonas Salk’s polio vaccine was rolled out. I remember my mother telling me that everyone was going to be getting a new medicine and I vividly recall my entire class lining up to get the injection from the school nurse.

I remember my mother being very happy about it because a boy in the neighborhood—a friend of my brother—had had polio and now wore leg braces and used crutches. When she saw him, she would sometimes say, “too bad the vaccine came too late for John.”

Nurses’ role in addressing vaccine concerns.

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2021-04-26T11:50:12-04:00April 5th, 2021|COVID-19, infectious diseases, Nursing, patient engagement, Public health|0 Comments

The Bittersweet Reality of a Nurse’s Limits in Providing End-of-Life Care

Three young patients on the same trajectory.

Image by strikers/pixabay

I have recently spent time with a few young patients all on the same sharp trajectory towards their final day of life. All had different diagnoses, and on the days I had the privilege of being their nurse, they were each at different points on that trajectory.

M. was just four days away from dying, though he and all his medical caretakers thought at that point that he had at least a few more weeks.

J. was a couple of months away from dying, and on my shift with her, she knew her situation was bad but remained hopeful for some last-ditch interventions.

R. was well-appearing outside of an unsteady gait and slight sideways drift of her eyes. She maintained levity and a hopeful innocence in the first few hours of my shift with her before I took her to her MRI scan. As I watched her MRI images appear with a clear and tragic diagnosis, I heard the physicians outside of earshot from the MRI table discuss the inoperable, inevitable turn this would take for her in the very near future. R. didn’t know yet that her budding dreams for adulthood would not come to pass, and it felt […]

Hui-wen Sato, MSN, MPH, RN, CCRN2021-04-02T15:27:22-04:00March 31st, 2021|Nursing|1 Comment

AJN April Issue Highlights: Chemotherapy-Induced Neuropathy, a Primer on ‘Big Data’ and Machine Learning, More

“Nurses need to be out in the community—in schools, libraries, senior centers, wherever our neighbors gather—to help address COVID-19 vaccine hesitancy and ensure that people have accurate information.”—editor-in-chief Shawn Kennedy in her editorial, “A Most Welcome Spring”

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

What is a mental health crisis?

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Studies of safety and quality will determine the optimum use of this option.

Some obvious and potential benefits.

Risks, concerns, ongoing questions.

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‘A Most Welcome Spring.’

Remembering the relief at having a polio vaccine.

Nurses’ role in addressing vaccine concerns.

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Three young patients on the same trajectory.

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