Suicide Among Nurses: Poorly Documented and Unacknowledged

Photo © Wavebreakmedia Ltd UC25/ Alamy Stock Photo

When we all worked eight-hour shifts, “my” shift was evenings. Most nights I reported off to the same night nurse, a woman about my age who was an excellent nurse and also simply a nice person to be with. One evening I came to work to learn that my new friend would not be at work for a while. She had tried to kill herself.

A surprising lack of suicide data for nurses.

Did you know that there are national data on the suicide rates of physicians, teachers, police officers, firefighters, and military personnel, but none pertaining to suicides of nurses? Or that many hospitals have long offered screening for suicide risk to medical staff and medical students, but not to nurses? The lead news story in this month’s AJN, “Suicide Among Nurses,” highlights these and other findings of a recent National Academy of Medicine discussion paper, “Nurse Suicide: Breaking the Silence.”

Many reasons for this silence.

Judy Davidson, a nurse scientist at the University of California San Diego and the lead author of this paper, points out that there are many reasons for the silence around this issue. She notes that suicide data in general […]

2018-08-20T09:32:01-04:00August 20th, 2018|Nursing|2 Comments

It’s Spring. Time to Think about Lyme Disease

Ticks Ixodes pacificus (shown here in CDC image) and Ixodes scapularis are known vectors of Borrelia burgdorferi (Lyme disease)

National data confirm that diagnoses of Lyme disease begin to rise each year during the month of April, then rapidly reach their peak in June and July. Just in time for “Lyme season,” readers can learn more about the disease in “Lyme Disease: Diagnosis, Treatment, and Prevention” in this month’s AJN.

Lyme disease was first recognized in 1975 in Lyme, Connecticut. From 492 confirmed cases in 1982 (the first year in which Lyme was a reportable disease) to more than 35,000 confirmed and probable cases in 2016, the causative organism, Borrelia burgdorferi, has continued to expand its geographic reach. The CE article notes that these numbers may be undercounts and cites analysis of laboratory and medical claims data from 2008 suggesting that the true number of annual diagnoses may actually be between 240,000 to 444,000.  […]

A Closer Look at Preventing C. Diff Transmission

Clostridium difficile/ CDC

It’s estimated that Clostridium difficile (C. diff) causes about 450,000 infections and 15,000 deaths each year. Recently, on Facebook, AJN’s question of the week asked about isolation precautions for patients with C. diff. Most readers could not provide the correct answer to the multiple choice question.

In this month’s issue, “Six Things You Can Do Today to Prevent Hospital-Onset C. difficile Tomorrow” offers a quick update of the best ways to prevent C. diff infection and transmission in hospitalized patients.

Author and infection prevention nurse Nancy O’Connor explores the finer points of key basics, including the importance of maintaining a high index of suspicion for cases, performing excellent hand hygiene, and cleaning all surfaces in a case patient’s room with a bleach solution. (And did you know that if the patient remains in the same room posttreatment, after symptoms have resolved, the room should be terminally cleaned to avoid reinfection?)

Isolation precautions and C. diff.

So, what about isolation precautions, which need to be started as soon as C. diff is suspected? Most respondents to our Facebook question thought that standard precautions were sufficient until a C. diff diagnosis was confirmed. But if this “rule-out” patient with diarrhea is positive, does s/he begin to shed C. diff only after the infection has […]

2017-09-22T11:21:11-04:00September 22nd, 2017|infectious diseases, Nursing|0 Comments

The Role of Prevention and Standardized Care in Improving CKD Outcomes

Slowing Chronic Kidney Disease Progression

Most nurses have worked with patients with chronic kidney disease (CKD). Their condition may have been related to diabetes, high blood pressure, an acute infection, or other assaults on the kidney. I’ve tended to see a diagnosis of CKD as the beginning of an inevitable decline. Certainly, “prevention” didn’t seem a relevant concept at this point; my role was to assess and monitor, teach and support, and hope for the best.

Fig. 1. The Nephron. Blood flows into the nephron through the glomerulus. Filtrate from the glomerulus flows into Bowman’s capsule, then through the proximal tubule, the loop of Henle, and the distal tubule, a series of tubules that modifies the filtrate primarily by reabsorbing water and […]

2017-03-14T12:02:17-04:00February 15th, 2017|Nursing, Public health|0 Comments

Metabolic Syndrome: Lifestyle Factors and Prevention

Metabolic syndrome: one-third of U.S. adults.

Cycling Mother and Daughter, Netherlands/via Wikimedia CommonsConversations about health—whether between neighbors or between clinicians and patients—often revolve around weight problems, blood pressure, blood sugar, and cholesterol levels. Taken together, these are the cardiovascular risk factors referred to as metabolic syndrome.

In the United States, more than one-third of all adults have metabolic syndrome. This is an astonishing figure, especially because these risk factors can be modified.

What keeps some who are obese or overweight ‘metabolically healthy’?

In recent years, researchers have learned that some people who are overweight or obese do not demonstrate the other risk factors that are part of metabolic syndrome, and therefore these people have a lower-than-expected risk of cardiovascular disease. In a study reported in this month’s AJN (“Examining the Links Between Lifestyle Factors and Metabolic Syndrome“), a group of Taiwanese nurse researchers set out to learn whether there might be lifestyle factors that keep this subgroup of people “metabolically healthy,” protecting them from the other cardiovascular risk factors that usually come with extra weight.

Lifestyle factors associated with prevention.

Dr. Shu-Hung Chang and colleagues performed community-based physical exams on more than 700 people in northern Taiwan and questioned them about lifestyle factors including smoking, drinking, exercise, and the foods they ate. The researchers […]

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