Getting Nurses with Substance Use Disorders the Help They Need

“Nurses have distinctive risk factors associated with the work environment that may increase the probability of developing an SUD.”

In my previous roles as the director of the emergency department and pediatric intensive care unit, I worked with nurses who were enrolled in the Intervention Project for Nurses (IPN), which is a substance use disorder (SUD) assistance program.

My colleagues would often ask me why I’d hire anyone who was enrolled in this program. My response was that these are the ones who are getting help and trying to recover. I feel safe with these nurses because I know they are being monitored and receiving treatment—it’s the other nurses that I worry about. […]

2022-10-12T09:33:38-04:00October 12th, 2022|career, Ethics, Nursing, patient safety|0 Comments
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PPE’s Contribution to the Plastic Pandemic

“It’s estimated that it could take 450 years to completely decompose a surgical mask.”

Personal protective equipment (PPE) is critically important for health care workers; however, use of PPE is also contributing to environmental disaster. The COVID-19 pandemic and the monkeypox outbreak underscore how crucial protecting frontline workers is for their health and for public health at large. What is yet unclear are the environmental implications of our extensive PPE use during the pandemic. Nurses must have prominent voices at the table when discussing the future of PPE and how to deal with waste.

In the United Kingdom alone it was reported that over a period of just 53 days, 748 million PPE items were used in hospitals. In 2020, over 6.76 billion PPE items were distributed in England, three times the usual amount. Several countries reported over a 350% increase in medical waste during the height of the pandemic. During two years of the pandemic, it’s estimated that over 900 million tons of plastic waste was generated.

This ‘plastic pandemic,’ which is now a global threat that has been exacerbated by the COVID-19 pandemic, began in the 1850s when early forms of plastic began replacing natural materials. Despite recycling efforts, over 60% of plastics are estimated to remain […]

2022-09-20T09:37:57-04:00September 20th, 2022|environmental health, environmental health, Public health|0 Comments
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We Haven’t Made You Better: Orthopedic Trauma and Emotional Healing

Learning that healing the body isn’t always enough.

For much of my career as a trauma ICU nurse and orthopedic trauma nurse practitioner, I focused on building my knowledge of pathophysiology and mastering the assessment and procedural skills required to care for trauma survivors. After a decade of practice, I felt like I had entered the “expert” phase of clinical competence described by Dr. Patricia Benner in AJN in 1982.

But I was completely ignorant of a giant hole in my practice. A trauma survivor pointed out this gap during a routine clinic visit. Ms. H was six months removed from an ankle fracture she’d suffered in a motor vehicle collision on her way to work one morning. On exam, she had regained full strength and range of motion, the fracture was healed on radiographs, and her pain was limited to a minor ache after extended activity. She’d healed remarkably.

I told her that she had done an excellent job with her recovery and could resume her life, including going to work. I’ve come to believe that Ms. H’s response to this assertion changed my entire perspective on patient care. “I can’t go back to work,” she said. “Since the accident, I can’t get in a car without having panic attacks.”

I […]

2022-09-16T11:39:37-04:00September 16th, 2022|Nursing, nursing research, Patients|0 Comments
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Primary Nursing of Medically Complex Children in the ICU Increases Parental Trust

Differing views about quality of life.

Photo by Pat Smith/Pexels

As medical care has become increasingly advanced in its ability to prolong life in the face of serious, chronic illness, it has also presented complicated challenges for both the caregivers and care-receivers alike. This holds especially true when we venture into the thorny, subjective realm of “quality of life.”

Sam was a patient with serious chronic illness and severe developmental disability who had been in and out of our pediatric ICU for many years. His most recent nine-month hospitalization had been the most frightening and uncertain thus far, and the gap between the perspectives of the medical team and Sam’s mom had became more apparent. The medical team speculated whether Sam was approaching the end of his life, while his mom asked us to continue doing all we could to maximize Sam’s physical longevity.

Unspoken questions also involved our struggle to measure what exactly comprises “enough” quality of life to justify the continued offering of health care resources. It’s an inevitable struggle with scarce resources and the monetization of quality of life, particularly with a chronically ill, severely disabled child who can feel so “other” to those of us living “normal” lives.

Parents come to our unit seeking care […]

2022-09-14T10:01:23-04:00September 14th, 2022|family experience, nursing roles, pediatrics|1 Comment
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Understanding Trauma-Informed Care in Nursing Practice

When I first started my nursing career, I worked on the pediatric inpatient unit. I remember feeling sad and upset when getting report on my patients who had experienced terrible trauma in their young lives. I wondered how they would make it to and through adulthood after having survived abuse, neglect, witnessing violence, or serious illness or injury.

That was over 20 years ago, and now many of these patients are showing up in the health care system carrying their pain and bad memories with them. They may be the adult we meet with a substance or alcohol use issue, chronic pain, or help-rejecting behaviors. They might be the patient whom colleagues have labeled “difficult.” Or they might be chronically late for appointments or fail to show up at all. Frequently, people with a history of trauma can be further traumatized by an interaction with an uncaring health care system and choose to avoid getting the care they need. They may be experiencing symptoms of PTSD along with their other reasons for seeking health care.

Practicing trauma-informed-care (TIC) can help address this problem. June is PTSD awareness month, and we’d like to highlight our April CE feature, “Trauma-Informed Care in Nursing Practice.” Authors Elizabeth Dowdell and Patricia Speck point […]

2022-06-15T14:09:56-04:00June 9th, 2022|Nursing, patient engagement, Patients|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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