‘Just’ a Backache: Red Flags for Serious Underlying Conditions

A common complaint in the ED.

Years ago, as an ED nurse, I saw many patients whose primary complaint was back pain. Most of these were from recent trauma, such as after the patient had sustained a fall or was involved in a motor vehicle accident or other injury-causing incident. In one dramatic case, a patient came in with sudden, severe back pain, not realizing he had been stabbed!

I remember a young man who came in on a Sunday, complaining of a backache that had developed over the prior few weeks. He assumed it was just a muscle strain from working out, but finally sought treatment because the pain wasn’t letting up and had spread to include pain and numbness down one leg. As it turns out, he had a badly herniated disc.

Emergency departments fill a care gap for many patients.

Today, patients come to EDs not just for emergencies or even “urgencies”—EDs are often the only place an individual may have access to care. For some patients with ongoing health problems, an ED is where they go when the pain or disability has finally become too much to bear.

What red flags should nurses look out for with back pain in the ED?

“[N]onspecific low back pain that does not resolve with self-care and prompts patients to seek treatment in an ED may result from a serious underlying pathology…”

This month’s CE article, “Assessing Back Pain in Patients Presenting to the ED” (free to […]

Journal Watch: Short Takes on Recent Notable Research

This month we’re spotlighting our Journal Watch department. Here you can find short takes giving just the essential take-home points from notable studies that have been recently published in respected journals.

If you need to keep up with current research but don’t have time to do so, we suggest you start here each month.

The following six short articles will be free for the month of July.

Deprescribing in patients with a history of falls isn’t so easy, for either clinicians or patients. “Multifaceted, multilevel approaches are needed to overcome common barriers.”

Many women who have ovarian cancer still receive aggressive end-of-life care despite recommendations emphasizing early palliative care . . . and nonwhite women are more likely to receive aggressive care.

Discontinuation of thyroid hormone replacement is possible in some cases.
“Nearly one-third of patients remained euthyroid after discontinuation.”

Changes in ED use during the pandemic.
“Shifts in the pattern of ED visits . . . highlight the need for mental health, substance abuse, and violence risk screening and prevention during public health crises.” […]

AJN July Issue: Postpartum Depression, Red Flags for Back Pain in the ED, More

“The deeper into the swamp we walked, the greater the stillness. Negativity and angst dissolved. Silence seeped into our spines, relaxing our amplified neural conversations and untying cranky muscles.”—Pamela Sturtevant in her Reflections essay, “Of Swamps and Pandemics”

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

CE: Assessing Back Pain in Patients Presenting to the ED

This article describes the red flags that can alert clinicians to serious underlying conditions in patients who seek emergency care for back pain.

CE: Postpartum Depression: A Nurse’s Guide

The author presents the latest information on this debilitating mood disorder, including risk factors; consequences for the mother, partner, and baby; and screening and treatment options.

Legal Clinic: Crisis Standards of Care

The author discusses the ethical issues that arise when the standards of care shift from conventional to crisis and explains the legal implications for nurses. […]

2021-06-30T09:52:35-04:00June 30th, 2021|Nursing|0 Comments

What to Know About the ACA After Third Failed SCOTUS Challenge

As trusted sources of information related to health and health care, nurses should be informed about health care laws that govern access to care.

The issue.

On June 17, 2021, the Supreme Court of the United States (SCOTUS) rejected the latest constitutional challenge to the Affordable Care Act (ACA). The ACA lawsuit was linked to the Tax Cuts and Jobs Act of late 2017, which “zeroed out” the penalties imposed by the ACA’s controversial individual mandate requiring people to have health insurance. Following this, in February 2018 a coalition of 18 states and two individuals filed a lawsuit challenging the legality of the ACA because the individual mandate was unenforceable.

While most pundits initially dismissed the seriousness of the threat of the lawsuit, this changed in June 2018 when the U.S. Department of Justice under President Trump expressed support for the suit, asking the court to strike down not the entire law but just the ACA’s prohibitions against insurers’ denying coverage to people with preexisting conditions and against charging higher premiums because of health status (the Justice Department later expanded its support of the lawsuit to include repeal of the entire ACA). Historically, it is unusual for the Justice Department to oppose […]

Demystifying Clinical Research: A Series for Nurses Breaks It Down

No matter where you are working as a nurse, research is impacting the work you do. The articles in our two Evidence-Based Practice (EBP) series (the EBP Step by Step series and the EBP 2.0 series) remain some of the most-read AJN articles. However, you can’t develop or implement EBP projects without reading and understanding research articles.

Like learning a foreign language.

Clinical research can be intimidating for those not familiar with it. I liken it to learning a foreign language. And as with learning a new language, it makes sense to start at the basics and build your vocabulary as you go. Our latest series, Nursing Research, Step by Step, “is designed to give nurses the knowledge and skills they need to participate in research, step by step.” […]

2021-06-24T11:27:57-04:00June 24th, 2021|Nursing|0 Comments
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