Off the Charts

A Message from Frontline Nurses: Let’s Keep the Real Enemy in Sight

The recent protests against stay-at-home restrictions across the country are painful to watch for nurses most affected by the pandemic, those caring for COVID-19 patients. Four RNs working in hospitals in New York City who are graduate students at the Lienhard School of Nursing at Pace University decided to work together with one of their professors to share their thoughts on behalf of nurses on the front lines.

There are refrigerator trucks filled with bodies outside our hospitals. Many of us have to pass by them when we go into work, knowing that among those bodies are the patients we cared for yesterday and when we leave 12 hours later, some of the patients we cared for today will join them. Even harder to handle is the knowledge that among those bodies may be a colleague or friend, fellow nurses who caught COVID-19 while caring for others. It is heartbreaking and terrifying because we know that we too could end up in a body bag shelved in a refrigerator truck.

So, it is no wonder that the sight of people protesting protective measures generates such strong emotions for us—anger, fear, sadness. Anger that in choosing to ignore restrictions, or insisting on the right to risk their own health, […]

Guest Author2021-01-21T11:07:20-05:00April 29th, 2020|infectious diseases, Nursing, nursing perspective, Public health, students|7 Comments

May Issue Highlights: Pain Management in Critical Care, ECG Interpretation Basics, More

“The reality of an insufficient health care workforce and underfunded health care system is all too evident. . . . Perhaps things will change after this, and we will be ready the next time. I hope so.”—editor-in-chief Shawn Kennedy in her May Editor’s Note, “Life, Interrupted“

In case you’d like a break from COVID-19 headlines and want to keep up with some other nursing and health care topics, the May issue of AJN is now live. Here are the highlights:

Original Research: Exploring the Effects of a Nurse-Initiated Diary Intervention on Post–Critical Care Posttraumatic Stress Disorder

The authors examine how collaborative diary writing—by patients, visitors, and interdisciplinary team members—can affect the development of posttraumatic stress disorder and symptom severity in critical illness survivors.

CE: Managing Pain in Critically Ill Adults: A Holistic Approach

A review of the Society of Critical Care Medicine’s PADIS guidelines—and how they go beyond the earlier PAD guidelines—in providing specific guidance related to assessment and management of pain, use of opioids in critical illness, and use of adjunctive analgesia.

New Series: Strip Savvy: A Case of Bradycardia and Extreme Fatigue

This is the first article in a new series on the basics of electrocardiography (ECG) […]

Diane Szulecki, editor2020-04-27T09:02:16-04:00April 27th, 2020|Nursing|0 Comments

Coronavirus Casting Environmental, Climate Issues Into Sharp Relief

The COVID-19 pandemic highlights the vital link between public health and the environment.

Since 1970, April 22 has been designated Earth Day. The theme of this year’s observations, held digitally due to the pandemic, is climate action, with the organizers calling climate change “the biggest challenge to the future of humanity.”

The biggest immediate challenge facing humanity is coronavirus. Yet, just as the pandemic’s economic fallout highlights the interconnectedness of health and the economy, this crisis underscores the ongoing environmental emergency and its link to public health.

Air pollution and COVID-19 deaths.

Since coronavirus first emerged, there’s been speculation about a link between air pollution and severe illness or death. Early this month, a nationwide study conducted by researchers at the Harvard T.H. Chan School of Public Health offered evidence of a connection: even a small increase in long-term exposure to fine particulate matter—dangerous inhalable solids or liquid droplets in the air—is associated with a large increase in the COVID-19 death rate.

The inhalation of fine particulate matter is known to cause inflammation and damage to the lungs, making a person more susceptible to asthma, heart conditions, and other health problems. Fuel combustion—for example, automobile and industrial emissions—is one of the main sources of these microscopic pollutants.

Communities […]

Corinne McSpedon, senior editor2020-04-22T08:31:24-04:00April 22nd, 2020|environmental health, Public health|0 Comments

The U.S. Still Can’t Manage COVID-19 Testing: Why Is This Such a Big Deal?

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. Published April 20.

How is it that we in the U.S. make up 4% of the world’s population but account for more than 31% of global COVID-19 cases? Because at the start of the pandemic we weren’t prepared to test quickly and widely—and incredibly, after three months’ time, we still aren’t.

Coincidentally, both the U.S. and South Korea saw their first cases of COVID-19 on January 20. Two weeks later, South Korean scientists had perfected a diagnostic test for the virus, and infected people began to be identified and isolated.

Meanwhile, in the U.S. a series of problems and poor decisions held back test development. In early March, as the number of cases of COVID-19 exploded in parts of the country, Health and Human Services Secretary Alex Azar promised that by March 14, labs would be running four million tests per week. As of April 20, the total number of SARS-CoV-2 tests performed in the U.S. since the pandemic began was only 3.8 million, according to covidtracker.com. Our testing capacity is frighteningly low. Estimates of an adequate […]

Betsy Todd, MPH, RN2020-04-20T12:32:03-04:00April 20th, 2020|infectious diseases, Nursing, Public health|0 Comments

COVID-19: Where Do We Go From Here?

By AJN editor-in-chief Shawn Kennedy

It’s mid-April and I feel like I’m in one of those B-rated movies of the 1950s—where the atomic bomb hit and everyone is sequestered in bunkers, only venturing out to forage for food.

I’m entering our 5th week following stay-at-home recommendations and I guess it’s paying off—New York (where I usually work) and New Jersey (where I live) seem to be seeing a slight “flattening of the curve.” (Does anyone not know about the COVID-19 curve? See this site by the University of Michigan for an explanation).

But that good news is tempered by the fact that some states have yet to see their peak. In addition, we’ve yet come with grips in how to deal with the spread of the coronavirus in nursing homes, prisons, and shelters.

It’s worrisome to me that there is already talk of relaxing stay-at-home orders and social distancing before we have sufficient testing to have a clear understanding of how the disease spreads, before some states have reached their peak, and before we have refined the process of supplying and protecting health care workers. No one doubts that the economic shutdown is causing tremendous suffering, but without a firm grasp on how best to contain this […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2020-04-16T10:26:04-04:00April 16th, 2020|Nursing|0 Comments

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The COVID-19 pandemic highlights the vital link between public health and the environment.

Air pollution and COVID-19 deaths.

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