May Issue: Addressing Nurse Burnout, New Chest Pain Assessment Guidelines, More

“This is the third Nurses Day celebrated since the start of the pandemic and nurses’ work has gotten more recognition than ever. But is that recognition enough?”—AJN senior clinical editor Christine Moffa in her editorial, “Honoring Nurses Where They Need It”

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

Original Research: Combating the Opioid Epidemic Through Nurse Use of Multimodal Analgesia: An Integrative Literature Review

This review presents strong evidence on the benefits of multimodal analgesia in reducing opioid use for pain management in the acute care setting.

CE: Chemicals in the Home That Can Exacerbate Asthma

The authors describe how the use of cleaning and disinfectant products may affect asthma and asthma-related symptoms and report the findings of a recent study they conducted that identified how these products could reduce asthma control in older adults.

Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19

This quality improvement project evaluated the use of serenity lounges—dedicated rooms where nurses can take workday breaks to relax and rejuvenate—and massage chairs on nurses’ anxiety, stress, and burnout.

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2022-04-25T09:32:36-04:00April 25th, 2022|Nursing|0 Comments

The Legacy of the Asthma Nurse Who Really Listened to a Five-Year-Old

My mum tells me that when I was two years old, I would regularly go blue, particularly when I was walking my sister to school on a cold, windy day. Alongside this, I coughed incessantly. My parents took me to the doctor’s surgery multiple times, and their concerns were dismissed by the GPs, or a course of antibiotics given.

One day when I was particularly unwell, my mum was unable to get a doctor’s appointment but was able to see one of the practice nurses. The nurse identified intercostal recessions and immediately got a doctor to examine me. The doctor asked my mum how long I had been asthmatic; that was the point at which I finally received the diagnosis that linked me into a nurse-led clinic for long-term monitoring.

The nurse was Mr. Pierce*, a man who initially seemed to me scary, authoritative, and old. His voice boomed and filled his modest consulting room. He always pushed open the door to the patient waiting room with considerable energy and vigor, loudly announcing patient names, a habit which made me jump without fail.

Trusting the patient’s expertise.

Mr. Pierce was very much ahead of his time in terms of acknowledging patients’ expertise in their own health. He listened to my account of symptoms, asking my parents […]

2020-12-02T10:58:37-05:00December 2nd, 2020|Nursing|0 Comments

Enterovirus D68: Precautions, Surveillance, Yes; Alarm, No

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

EV68-infographicAs news coverage focuses on the latest clusters of suspected—and, in some instances, confirmed—cases of human enterovirus D68 (EV-D68) as they occur in successive regions of the U.S., here’s a quick primer on what is known about EV-D68.

Is this a new, dangerous virus?
EV-D68, a non-polio enterovirus, is not a “novel” virus—the term used to describe emerging infections such as SARS and MERS. It’s more accurate to describe it as the CDC does: it is an “increasingly recognized” cause of respiratory infections, especially in children.

EV-D68 was first isolated in 1962. While reports of EV-D68 since then have been sporadic, the CDC in 2011 reported on clusters of this viral infection in Georgia, Pennsylvania, and Arizona as well as in Asia and Europe. It’s likely that there are hundreds or even thousands of EV-D68 infections every year in the U.S. But as with many other viral infections, they will range in severity, and an infection that looks like “a cold” isn’t usually brought to the attention of a health care provider.

According to the CDC, most enterovirus infections are actually asymptomatic; this may be the case with EV-D68 as well.

Diagnostic testing for EV-D68 involves RT-PCR and gene sequencing. Most hospital labs therefore are unable to test for it. Some readily available […]

What to Teach Patients and Their Families About Asthma

What do you need to know about asthma, and what should you teach your patients about its prevention and management? This month’s CE article gives a comprehensive and accessible overview, with medication, symptom, and common allergen tables, as well as advice like the following about the use of “action plans,” which may be particularly helpful with patients with “moderate or severe persistent asthma, a history of exacerbations, or poorly controlled asthma.” 

Action plans should be simple and easy to use. Many use a traffic light analogy, describing green, yellow, and red zones for which specific actions are prescribed. In the green (“go”) zone, patients’ [peak expiratory flow rate] PEFR is 80% to 100% of their personal best and they have no symptoms. These patients can continue using their daily medications and taking steps to limit exposure to triggers, as described in their plan. When patients’ PEFR is 50% to 80% of their personal best and they have symptoms, they’ve entered the yellow (“caution”) zone, and practitioners may consider prescribing alternative antiinflammatory medications and, possibly, a higher dose or more frequent use of the rescue medication. Patients whose PEFR drops below 50% of their personal best and whose symptoms fail to improve significantly with prescribed rescue medications are in the red (“danger–stop”) zone. They should increase medication as indicated in their action plan and call their health care provider immediately. If unable to reach their provider, they should stop what they’re […]

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