Off the Charts

If I Want to Wear a Face Mask to Prevent COVID-19, Why Shouldn’t I?

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. Published. March 6; updated March 12.

Times are uncertain. We don’t know how the spread of the new coronavirus will play out, or what parts of the country will be affected next. Many people continue to insist that wearing a mask in public places is “added insurance” against infection. But the reasons for NOT wearing a face mask far outweigh the purported benefit of keeping your nose and mouth covered when you’re out and about.

First, some background.

Health care workers use two main kinds of mouth and nose protection: either a regular surgical face mask, or an N95 respirator.

The purpose of a surgical mask is to prevent the wearer’s respiratory secretions from contaminating other people or surfaces. This is an example of “source control” in preventing infections. It is the reason the surgical team wears masks during operations and other invasive procedures.

N95 respirators look very much like face masks. They are designed to protect the wearer from inhaling hazardous particles (infectious agents, dust, etc.). Health care workers wear these when caring for people with COVID-19 or other serious respiratory infections.

But at least a face mask provides a physical barrier. Why shouldn’t […]
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Betsy Todd, MPH, RN2020-03-11T12:10:37-04:00March 6th, 2020|infection control, Nursing, Public health|0 Comments

Defining Death

My first encounter with brain death was back in the early 1970s. I was a new RN in a shock-trauma unit. We admitted a 17-year-old young woman who had attempted suicide by jumping out of a fifth-floor window. If it wasn’t awful enough, I remember it was Thanksgiving weekend and she had been home from college.

Angiograms of normal blood flow in an active brain (at left) and lack of blood flow indicating
brain death. Photos © Fusionspark Media Inc.

As one might imagine, she sustained massive injuries, including severe head trauma. She had been intubated at the scene and was on a mechanical ventilator. Her pupils were fixed and dilated, and she had no spontaneous respirations and virtually no brain activity, according to electroencephalography (EEG) studies.

A gradual refinement of criteria.

I recall that there had to be three consecutive EEGs done before we could remove the ventilator. There was no ethics committee or formal meetings with hospital attorneys or administrators—just the physician, the family, and the pastor. And then the patient’s siblings and grandparents came to say goodbye. It was heart-wrenching.

Things have gotten more defined […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2020-03-05T08:21:37-05:00March 5th, 2020|Nursing|0 Comments

COVID-19 for Nurses: Skip the Rumors and Stick to the Basics

(Published: February 28. Editor’s note: much information in this post is now dated and the post should be read only as a response to a particular moment in time. COVID-19 is now officially a pandemic and has rapidly spread worldwide. While rumors and misinformation were, sadly, already very much in play when this was written, and the overall tone of this post was neutral and descriptive according to our knowledge at that current moment, the post only remains live for archiving purposes. Our most recent posts on the crisis can be found here.)

In the U.S. at the time of this writing, the major risk presented by the current novel coronavirus (COVID-19) is not from the disease itself but from misinformation. Rumors, misinterpretations, and conspiracy theories are being transmitted at a rate far greater than that of the coronavirus itself. While the situation is evolving rapidly and things can change quickly, our understanding of the illness has also grown in a remarkably short period of time.

So, is this a pandemic?

In an NPR interview this week, WHO director-general Tedros Adhanom Ghebreyesus said the term is used to suggest that the spread of a new infection is out of control and doing significant damage worldwide. We are not quite there yet. COVID-19 transmission in China appears to have plateaued, and, while the virus has been detected in numerous other countries this week, several countries have also been successful in controlling the spread of COVID-19 within […]

Betsy Todd, MPH, RN2020-03-19T14:34:33-04:00February 28th, 2020|infectious diseases, Public health|13 Comments

The Sound of Silence: Racism in Nursing

“In the end, we will remember not the words of our enemies, but the silence of our friends.” -Dr. Martin Luther King

One of the conundrums I face when writing stories from my nursing career is the question “whose story is it?” For instance, does observing an act of racism give the observer the right to tell the story of what happened to another person? Does telling the story with the intent of exposing the ugliness of racism make it okay?

by julianna paradisi

It’s February, Black History Month. How can a white woman, a registered nurse, discuss race issues in a profession in which only 7.8% of the workforce is black without sounding ignorant, or worse, racist herself? Once or twice in the past I’ve made well-intended comments that revealed my own blind spots when talking about race. Fortunately, these were brought to my attention by friends who understood my good intentions, however misguided. I’m grateful for their support, and compassion. Like learning a new language, using the right words when talking about race requires commitment, practice, and a little bit of courage.

‘Here’s the chart. Answer the man’s questions.’

Years ago, I encountered a surgeon I’d never met before who repeatedly asked me for […]

Julianna Paradisi, RN, OCN2020-02-26T09:39:39-05:00February 26th, 2020|Nursing|3 Comments

March Issue: Brain Death Criteria Update, Inadequate Physical Activity in Female Cancer Survivors, More

“. . . there is no underestimating the power of meaning to bolster individuals and the power of meaninglessness to sap them of the will to go on.”—Henry Bair, author of the March Reflections column, “Waiting for Jerry”

The March issue of AJN is now live! Here are the highlights:

Original Research: Arthritis-Related Functional Limitations and Inadequate Physical Activity Among Female Adult Cancer Survivors

This study uses data from the U.S. National Health and Nutrition Examination Survey to examine the extent to which functional limitations due to arthritis are predictive of low physical activity levels in female cancer survivors.

CE: Brain Death: History, Updates, and Implications for Nurses

The authors review the development of brain death criteria, describe recent controversies and criteria updates, and discuss considerations for nurses who care for patients declared dead by neurologic criteria. […]

Diane Szulecki, editor2020-02-24T09:40:14-05:00February 24th, 2020|Nursing|0 Comments