Inside an Ebola Treatment Unit: A Nurse Shares Her Experiences in Liberia

By Sylvia Foley, AJN senior editor

“It is extraordinarily difficult to establish an IV line in a dehydrated patient by generator-powered light while double gloved, with one’s goggles fogging.”—Deborah Wilson

Author Deborah Wilson at the Foya ETU cemetery. Photograph by Marcos Leitão.In one of this month’s CE features, “Inside an Ebola Treatment Unit: A Nurse’s Report,” author Deborah Wilson offers readers a rare look from the frontlines of the 2014 Ebola epidemic. Her stories about her patients and colleagues are as compelling as they are informative. Here’s a short overview of the article:

In December 2013, the first cases of the most recent outbreak of Ebola virus disease (EVD; formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.

In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Foya, Liberia for five weeks. This article describes her experiences […]

2017-07-27T14:39:21-04:00December 11th, 2015|infectious diseases, narratives, nursing perspective|4 Comments
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Fracking, Health, and the Environment: More Bad News

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

U.S. EPA / via Wikimedia Commons U.S. EPA / via Wikimedia Commons

Last month, Physicians for Social Responsibility and Concerned Health Professionals of New York released the third edition of their Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking. This document summarizes more than 500 peer-reviewed studies on hydraulic fracturing (fracking),  along with many government and investigative journalism reports.

Fracking involves drilling into the earth and injecting a mixture of water, sand, and chemicals into the rock at high pressure to release the gas inside. There is extensive evidence to demonstrate health risks, environmental damage, and contributions to climate change caused by this practice.

The compendium is intended for policy makers, researchers, journalists, and the public. Specific fracking-related problems identified in this body of literature include the following:

  • Public health impacts, including respiratory disease and congenital abnormalities
  • Air pollution
  • Water contamination
  • Soil contamination and its effects on agriculture
  • Radioactive releases
  • Inherent engineering problems
  • Occupational health and safety hazards
  • Impacts from fracking-associated infrastructure, including noise, light, and diesel pollution
  • Earthquakes and seismic activity
  • Climate change (primarily from methane leaks)

[…]

2016-11-21T13:01:42-05:00December 2nd, 2015|Nursing, nursing perspective, Public health|3 Comments
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As with Ebola Outbreak, Social Determinants of Health Crucial in Recent Rural U.S. HIV Outbreak

Rachel Parrill, PhD, RN, APHN-BC, is an associate professor of nursing at Cedarville University in Ohio

by banditob/flickr creative commons by banditob/flickr creative commons

This past fall, with the world watching, a crisis unfolded in West Africa that challenged our understanding of sociocultural environments, epidemiology, and health. The spread of Ebola and the intercontinental transmission of the disease exposed weaknesses in our epidemiological defense system. It also drew attention to the powerful role that cultural beliefs and practices can have on disease transmission during outbreaks.

In that same time frame, and with similar cultural etiologies, another infectious crisis played out much closer to home. The setting: the rural Midwest, in and around the small town of Austin, Indiana. The disease: HIV. The crisis: an unprecedented outbreak—one with incidence rates (up to 22 new cases a day at the height of the outbreak) estimated to be higher than those in many sub-Saharan African nations and transmission rates through injection drug use higher than in New York City. Contributing to this “perfect storm” were socioeconomic factors characteristic of many rural settings, including poverty, low education levels, limited access to health care, and few recreational or employment opportunities.

In my work as a faculty member in a rural Midwest setting, I introduce undergraduate and graduate nursing students to concepts of public health nursing and try to provide opportunities […]

2016-11-21T13:02:06-05:00August 25th, 2015|infectious diseases, Nursing, nursing perspective|0 Comments
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Legionnaires’ Outbreak in New York City: Some Basics for Nurses

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

11148_loresIn the largest U.S. outbreak of Legionella infection since 1976, when there were 221 cases and 34 related deaths in an outbreak at a Philadelphia American Legion convention, more than 113 cases of the disease have been diagnosed in New York City since mid-July. Twelve people have died.

Legionnaires’ disease is neither rare nor exotic; it is a type of community-acquired pneumonia (it can also be hospital acquired). Symptoms include fever, cough, and progressive respiratory distress. Legionella can also cause a milder, flulike illness known as Pontiac fever that generally resolves without treatment. Because many cases of Legionnaires’ disease are never actually diagnosed, mortality rates are difficult to determine, but the rate currently is estimated at 5% to 30%.

The CDC estimates that 8,000 to 18,000 people are hospitalized with Legionnaires’ disease each year in the U.S., yet only about 3,000 cases are diagnosed and reported. Most cases of Legionnaires’ disease are sporadic, unlinked to any outbreak. The infections often are not recognized as Legionnaires’ disease, for several reasons.

2016-11-21T13:02:09-05:00August 12th, 2015|infectious diseases, Nursing|1 Comment
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Medicare Turns 50: Familiar Opposition in 1965, Essential and Continuing to Evolve Now

President Lyndon B. Johnson signing the Medicare Bill at the Harry S. Truman Library in Independence, Missouri. Former President Harry S. Truman is seated at the table with President Johnson. Photo: National Archives and Records Administration. President Lyndon B. Johnson signing the Medicare Bill at the Harry S. Truman Library in Independence, Missouri. Former President Harry S. Truman is seated at the table with President Johnson. Photo: National Archives and Records Administration.

On this date in 1965, exactly 50 years ago, Medicare (part of the Social Security Amendments of 1965) was signed into law by President Johnson. The debate over government-sponsored health insurance is not new, and opposition to the creation of Medicare was similar to the opposition to the Affordable Care Act and driven by many of the same organizations and arguments.

According to a timeline at SocialSecurity.gov, Congressional hearings on the topic occurred as early as 1916, with the American Medical Association (AMA) first voicing support for a proposed state health insurance program and then, in 1920, reversing its position. A government health insurance program was a key initiative of President Harry Truman, but, as with the Clinton health initiative several decades later, it didn’t go anywhere because of strong opposition from the AMA and others.

AJN covered the topic in an article in the May 1958 issue after a health insurance bill was introduced in 1957. Yet again, one of the staunchest opponents was the AMA. In the September 1958 […]

2016-11-21T13:02:12-05:00July 30th, 2015|career, health care policy, Nursing, nursing perspective, Patients, Public health|0 Comments
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