DiversityNursing Blog

Sheila Key via www.goodnewsnetwork.org 

The Ice Bucket Challenge – you’ve all heard about it. Maybe even participated in it. Something that started last summer in Boston became a viral sensation across the country to raise awareness and money for ALS research. We’re happy to share this wonderful story with you. The money raised went to funding research that appears to slow down the disease and hopefully lead to a cure. This is great news!

It worked!

The Ice Bucket Challenge that flooded the Internet with videos of people getting drenched has led to a medical breakthrough.

Researchers have long known that a particular motor-neuron protein—named TDP-43—doesn’t function properly in 90 percent of ALS patients.

Now a grad student at Johns Hopkins Medical, in Baltimore, Maryland, is pretty sure he has figured out why. In experiments with mice, his team made a protein to mimic TDP-43, and after adding to the neurons, the cells came back to life.

“With any luck this could lead to the possibility of a cure or at least a slowing down of this terrible disease,” says pathobiology student Jonathan Ling. “We may soon be able to fix this in patients who have lots of accumulated TDP-43,” says Ling.

He published his discovery in the journal Science last week and credited funding from the ALS Association for making his team’s research possible–money raised through the viral Ice Bucket Challenge last year.

During the social-media sensation’s peak months of August and September, more than 17 million people—including many celebrities—uploaded wet, chilly videos of themselves and drove charitable giving to over $115 million, more than tripling what the organization had earned the year before.

Fixing the dysfunctional protein will take time, Ling and his professor, Philip C. Wong, Ph.D., said in a YouTube video announcing the breakthrough. Time and, undoubtedly, more research money.

Which is why the two are attempting to start the challenge anew.

“We want to… really push this work forward,” Wong says, as big orange buckets sneak into view on either side of the two men.

In the video, Ling and Wong each challenge three people to give more….your move, Bill Gates.

Although with the drought in California, they will probably need to drop glitter on themselves rather than buckets of water.

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Craig Silverman via Buzzfeed

This story is about a Nurse who was in a horrific car accident and had the presence of mind to set her 2 broken legs. She realized she’d most likely face amputation if she didn’t do something about it pronto! We think she’s brilliant to have kept her head and used her training in a very stressful situation.

The last thing Stacie Reis remembers before the accident is driving and eating an ice cream cone. Her next memory is of waking up in immense pain inside a mangled car.

Reis was driving on a highway in Northern British Columbia. For some reason, her car went off the road and tumbled down an embankment.

The crash broke both of her legs, as well as her sternum and pelvis. Her heart and lungs suffered contusions. Other parts of her body were fractured.

Reis is a nurse at the University Hospital of Northern BC. She knew from her training that her legs were seriously injured and needed to be set quickly or face amputation.

“The way they were pinned, it wasn’t natural,” she told the Prince George Citizen. “The nurse in me was like, ‘You need to straighten these out otherwise you’re going to cut off your blood supply, you’ll lose your legs.”

Reis picked up her legs and moved them to set them straight. “It was really painful but I did it,” she told Global News.

She spent the next 14 hours praying, thinking, and sleeping as she waited to be found.

The accident happened around 6:30 p.m. on July 4, when Reis was on her way back from visiting her dying grandfather. He died at 1 a.m. that night.

A group of friends finally found her around 8 a.m. the next morning, the Citizen reported.

The day after the accident, one of her fellow nurses set up a GoFundMe page to raise money for Reis’s recovery. It had hoped to raise $5,000 and is currently at more than $16,000. A fundraiser was also held in a pub on Prince George.

Reis has undergone five surgeries and a skin graft. She’s now able to take small trips on hospital grounds.

Here’s Reis and an adorable visitor who will eventually realize she was in the presence of Canada’s Most Badass Nurse.

Robert Gebelhoff via The Washington Post 

What are your thoughts about delivering a baby at home versus in the hospital? This article explores both options and points out that delivering a baby at home can be cheaper than in the hospital. After reading the article, we’re curious to hear your thoughts. Thank you.

Having a baby is expensive, and the biggest bills almost always come from the hospital.

But a new study from the University of British Columbia, published this week in the journal PLOS One, found that a lot of money can be saved by having the birth at home with the help of a midwife.

The practice is highly controversial in the United States, as some doctors say the practice can be dangerous and is tied to higher infant death rates. Others argue that with a regulated system for midwives, planning home births may reduce health-care costs for pregnant couples.

The UBC researchers looked at all home births attended by registered midwives in British Columbia over a four-year period, and found that for the first 28 days of a baby's life, planned home births saved an average of $2,338 (in Canadian dollars) compared to hospital births with a midwife. The savings were even greater when compared to hospital births with a physician, at $2,541.

Health-care savings continued even to the baby's 1st birthday, the study found, with at-home births saving $810 compared to hospital midwives and $1,146 compared to physicians. These averages account for all planned home births, even if the delivery actually ended up at hospitals due to unanticipated situations or complications requiring emergency cesarean deliveries.

"Mothers are keenly interested about the safety of home birth," said Patricia Janssen, author of the study and a UBC professor. "Having a baby is a healthy process for most people. ... The best place for women is not always a hospital."

She argues that home births are just as safe as those at a hospital, as evidenced by the lower health-care costs for parents who decide to deliver at home.

"Had there been hidden costs, we could have seen them in the health system," Janssen said.

Although out-of-hospital births make up less than 1 percent of total deliveries in the U.S., they have been on the rise between 2004 and 2009, according to the latest data from the Centers for Disease Control.

Previous studies looking at home births found similar health-care savings in the United States. One study, looking at Medicaid claims in Washington State, reported that vaginal hospital deliveries cost $2,971 more than at-home births. Hospital cesarean deliveries cost even more, at $5,550 higher than at-home births, the study found.

Amos Grunebaum, a specialist in maternal-fetal medicine at Weill Cornell Medical College, argued that Janssen's study only applies to Canada due to a few key differences between the Canadian and American health systems.

The Canadian system essentially works like Medicare, but for the entire population — so the discussion of increasing at-home births there is more broadly a matter of public spending policy. The country's midwifery system is also highly regulated at the province level. In British Columbia, all midwives are required to be registered with the College of Midwives of British Columbia to be permitted to practice.

In the United States, there is no blanket licensing system for midwives. Only 28 states legally authorize midwives to practice, but in other states, Grunebaum said, midwives can practice with a high school education.

"I don't even call them midwives," he said. "They are 'so-called midwives.' "

Even if the midwives are licensed, many doctors in the U.S. still urge mothers to go to the hospital for delivery. Grunebaum compared at-home births to going swimming at the beach without a lifeguard on duty or buying a car without seat belts. Even if there are no extra health-care costs reported in the first year of a baby's life, he said there's a higher risk for brain damage in babies that would be seen over the course of their first 10 years.

"A planned home birth is potentially more dangerous," he said. "Interventions in the hospital are meant to save people. ... We should bring the home to the hospital, not the hospital to the home."

Liz Szabo via USA Today 

As a Nurse, I bet you have an opinion on this story about the FDA’s approval of the pain medication, OxyContin, for children as young as 11 years old. If you’re a parent of a severely sick child, I wonder if your opinion is different? This is a controversial decision by the FDA and we welcome your thoughts on this story.

The Food and Drug Administration has approved the powerful narcotic painkiller OxyContin for children as young as 11. While doctors who treat young cancer patients hailed the approval, others expressed concern that prescribing OxyContin to children could put them at risk for addiction.

OxyContin, an extended-release version of the painkiller oxycodone, has gained notoriety in recent years because of its frequent abuse. People addicted to painkillers crush the pills so that they can be snorted or injected, producing a powerful high.

In 2010, Purdue Pharma reformulated OxyContin to make it more difficult to abuse.

The FDA notes that children generally have many fewer options for pain relief than adults. Because of that problem, the FDA asked Purdue to perform studies to see if the drug could be used safely in children ages 11 to 16 with pain caused by cancer, trauma or major surgery, said Sharon Hertz, a physician with the FDA's Center for Drug Evaluation and Research, in an interview on the agency's website.

The FDA approved OxyContin for children this age who need "daily, round-the-clock, long-term" pain relief for which there is no alternative, Hertz said. Doctors should only prescribe OxyContin in children who have already been treated with opiate painkillers and who can tolerate at least 20 milligrams a day of oxycodone.

Other than OxyContin, the only other long-acting painkiller approved for children is Duragesic, also known as fentanyl, Hertz said.

"Children are not treated with opioids very often and usually it's only for a limited period of time with close supervision by health care professionals," Hertz said. "Fewer daily doses may free patients for physical therapy appointments, allow them to go home from the hospital sooner and may help them to sleep through the night without waking up."

Doctors who treat pediatric cancer patients hailed the approval as a way to ease children's suffering. Children at the end of life aren't at risk of addiction.

Having additional long-acting painkillers "is going to be tremendously helpful for treating children with cancer pain or pain at the end of life," said Justin Baker, pediatric oncologist and hospice and palliative medicine doctor at St. Jude Children's Research Hospital. Long-acting medications prevent breakthrough pain, so that youngsters can feel comfortable and "focus their energy on being a kid instead of fighting their pain," Baker said.

But prescribing OxyContin to youngsters with short-term medical needs could be put them at risk for developing an addiction that haunts them long after they leave the hospital, said Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing. Teens are at higher risk of addiction than adults because the brain doesn't mature until about age 25. Studies show that about one in 25 high school seniors has abused OxyContin, said Scott Hadland, a specialist in adolescent medicine and substance abuse treatment at Boston Children’s Hospital and Harvard Medical School.

"Among adolescents who are prescribed OxyContin, a small but significant number are going to become addicted," Hadland said.

The number of prescription painkillers sold in the USA has quadrupled since 1999, according to the Centers for Disease Control and Prevention. More than 44,000 Americans die of drug overdoses each year. Some people who become addicted to prescription painkillers switch to using heroin, which has become cheaper and easier to access than OxyContin.

Kolodny said it's concerning that the FDA approved OxyContin for children without appointing an advisory panel to discuss the risks and benefits, a process traditionally used when the agency faces a controversial decision.

Hadland said doctors need to take special precautions when dispensing painkillers, such as prescribing limited amounts, so that people don't end up with extra pills that they don't need. Doctors should screen patients for drug and alcohol abuse before prescribing OxyContin, Hadland said. And doctors should check their state's prescription drug monitoring program, which allows them to see if patients have already received painkillers from other doctors.

Parents should be in charge of giving children the medication, instead of allowing teens to administer their own painkillers, Hadland said. Parents should keep painkillers locked away at all other time.