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DiversityNursing Blog

New York nurse blends art, healing

Posted by Alycia Sullivan

Mon, Apr 07, 2014 @ 01:47 PM

bildeAs a registered nurse in the cardiac surgery ICU at Beth Israel Medical Center, Valley Fox, RN, BSN, MA, AP, CCRN, witnesses the spectrum of life and death. 

Her days are full of pharmaceuticals, imaging studies and other visual elements, which she reinterprets into an artistic language that explores the relationship between body and spirit.

“I take inspiration from the hospital because that’s where I spend my time,” Fox said. “Being in the presence of those images and bodies, it comes through instinctively.”

In one piece of artwork Fox donated to the American Heart Association and the cardiac surgery unit, she subtly embedded a heart in the middle of a flower. Many people did not notice, but her colleagues on the unit spotted it immediately. 

“The heart is the center of everybody,” said Cathy Sullivan, RN, BS, MSN, FNP, CCRN, director of patient care services, Beth Israel Medical Center — Petrie Division. “Without your heart, you wouldn’t have a body or soul.” 

describe the imageBeth Israel Medical Center nurse Valley Fox, RN, recently completed abilde (1) month-long art exhibit at New York University’s medical sciences building called “Origins of Medicine.”
Mary Anne Gallagher, RN, MA, BC, director of quality, standards and practice at Beth Israel, envisioned a fetus and baby in one of Fox’s paintings, which the artist had not intentionally set out to create. “When you are in her presence, there’s a feeling of peace and comfort,” Gallagher said. 

Art came first for Fox, who was born with severe myopia. Her inability to see clearly beyond 10 inches went unrecognized until she was in kindergarten, when she received glasses. “As a child, I was always drawing because that’s how I processed reality,” Fox said. “I would play with Play-Doh. I was constantly doing artwork as a child.”

The school allowed Fox, a gifted student, to paint twice a week in her elementary school years, where she developed her skills and creativity. “Everyone has creative capacities,” Fox said. 

Her parents encouraged Fox to pursue “a practical degree” rather than art. After completing her nursing school prerequisites and waiting to be admitted to a nursing program, she turned to Chinese medicine. She completed a master of oriental medicine at the Atlantic Institute of Oriental Medicine in Fort Lauderdale, Fla., but the timing was not ideal to set up her own practice as an acupuncture physician. 

bilde (2)Still, healthcare intrigued her, and the opportunity to travel, move around and practice in different places cinched her decision to become an RN. She worked in Florida, Illinois and upstate New York before settling in New York City. Nursing is a career path she has not regretted. 

“Being a nurse is incredibly rewarding, to help patients when they are in tremendous need and offer support and listen,” Fox said. “I get to share intimate moments with total strangers, and then there are critical moments where we work together as a team and save someone’s life. It’s an incredible opportunity.” 

Fox credits her artistic background with the intuitive skills she draws from as a critical care nurse. She considers the interconnectivity of the mind and body and draws from her experience in medicine to pick up subtle clues. 

“Sometimes, that right brain element comes through, and we can sense a patient may code and prevent an emergency,” Fox said. 

Fox professionally displays and sells her paintings and recently completed a monthlong exhibit at New York University’s medical science building called “Origins of Medicine,” in which she explored the relationship between the mind and body in medicine.

“Valley looks at the patient as a whole and anticipates,” Sullivan said. “That’s the type of nurse you need, one who pays attention to detail. And artists pay attention to details.”
Source: Nurse.com

Topics: New York, Beth Israel Medical Center, nurse, art

Can you offer some advice on getting a job for an RN who has been licensed for 2 years, but who has worked as an RN for only 2 months?

Posted by Alycia Sullivan

Mon, Apr 07, 2014 @ 01:38 PM

Source: Nurse.com
Question:

Dear Donna, 

I have been an RN for two years, but have worked for only a couple of months because I got sick. No one wants to hire me without experience. My credentials are perfect. I reside in Florida and cannot relocate because I am a mother of small children. Can you offer some advice?

Wants to Work 

Dear Donna replies:

Dear Wants to Work,

Don't be discouraged. The job market is shifting and changing. Even though you are not a new nurse, read “New nurse, new job strategies” to see what's happening and learn creative ways to market yourself (www.Nurse.com/Cardillo/Strategies).

You should start volunteering as a nurse while you continue to look for paid employment. Volunteering is a great way to gain recent relevant experience, to hone old skills and learn new ones, build confidence and expand your professional network. Plus, volunteering often leads to paid employment as it is a way to get your foot in the door somewhere. Look for opportunities at your local public health department, a free clinic, the American Red Cross, a cancer care center or a blood bank. 

You also should attend local chapter meetings of the Florida Nurses Association (www.floridanurses.org). You do not have to be a member of ANA/FNA to attend meetings as a guest. This is a great way to reconnect to your profession, get up to date on issues and trends and further expand your network. Networking is well known to be a great way to find and get a job.

When what you're doing isn't working, it's time to try a new approach. You will be able to find work. You'll just have to look in new directions for employment and use a new approach to find and get those jobs. Persistence and determination will always win out in the end.

Best wishes,
Donna 

Topics: help, work, new nurse, Ask Donna, RN

The Evolution of Medicine

Posted by Alycia Sullivan

Fri, Apr 04, 2014 @ 11:03 AM

evolutionfomedicine resized 600

Modern medicine has helped lead to a surge in average life expectancy, which was only about 36 in the late 1800s. With humans routinely living into their 100s, advances in medical science are to thank. Let’s take a journey through the history of medical advancements.

Life expectancy by year
1850 36.6
1890 39.7
1900 48.3
1911 50.2
1921 55.7
1931 60.9
1941 64.5
1951 67.1
1961 70.3
1971 71.4
1981 73.1
1990 73.7
1992 74.2
1993 74.8
1995 73.9
1997 74.2
1998 74.5
1999 74.7
2000 74.8
2001 75.1
2002 75.4
2003 77.9
2004 78.3
2005 77.8
2006 77.7
2007 77.9
2010 78.7
2011 78.7

BC

Cancer
400 BC: Hippocrates uses the term “karcinos” to describe tumors. “Karcinos” evolved into cancer. It’s not yet known what causes cancer, with theories including imbalanced “humors” in the body.
Immunization and disease prevention
400 BC: Hippocrates describes mumps, diphtheria, epidemic jaundice and other conditions.
Mental illness
400 BC: Mental disorders are understood as diseases rather than symptoms of demonic possession or signs of having displeased the gods.

2nd century AD

Cancer
2nd century AD: Galen describes surgical treatments for breast cancer, which include removing early-stage tumors. But the surgeries are brutal and often fatal. For centuries, these rudimentary surgeries are the only treatment for cancer.

1100s

Immunization and disease prevention
1100s: The variolation technique is developed, involving the inoculation of children and adults with dried scab material recovered from smallpox patients.

1400s

Mental illness
1407: The first European establishment specifically for people with mental illness is probably established in Valencia, Spain.

1500s

Surgery and medical technology
1540 AD: English barbers and surgeons perform tooth extractions and blood-letting.

1600s

Mental illness
1600s: Europeans increasingly begin to isolate mentally ill people, often housing them with handicapped people, vagrants and delinquents. Those considered insane are increasingly treated inhumanely, often chained to walls and kept in dungeons.

1700s

Immunization and disease prevention
1798: Edward Jenner publishes his work on the development of a vaccination that would protect against smallpox. He tests his theory by inoculating 8-year-old James Phipps with cowpox pustule liquid recovered from the hand of a milkmaid, Sarah Nelmes.
Mental illness
Late 1700s: After the French Revolution, French physician Phillippe Pinel takes over the Bicêtre insane asylum and forbids the use of chains and shackles. He removes patients from dungeons, provides them with sunny rooms and allows them to exercise on the grounds. Yet in other places, mistreatment persists.

1800s

Surgery and medical technology
1818: Human blood is transfused from one person to another for the first time.
Mental illness
1840s: U.S. reformer Dorothea Dix observes mentally ill people in Massachusetts, seeing men and women of all ages incarcerated with criminals, left unclothed and in darkness and forced to go without heat or bathrooms.
Cancer & surgery/medical technology 
1846: Anesthesia becomes widely available, helping expand options for surgery. Among cancer patients, surgery to remove tumors takes off.
Surgery and medical technology
1867: British surgeon Joseph Lister publishes Antiseptic Principle in the Practice of Surgery, extolling the virtues of cleanliness in surgery. The mortality rate for surgical patients immediately falls.
Immunization and disease prevention
1881: Louis Pasteur and George Miller Sternberg almost simultaneously isolate and grow the pneumococcus organism.
Mental illness
1883: Mental illness is studied more scientifically as German psychiatrist Emil Kraepelin distinguishes mental disorders. Though subsequent research will disprove some of his findings, his fundamental distinction between manic-depressive psychosis and schizophrenia holds to this day.
Surgery and medical technology
1885: The first successful appendectomy is performed in Iowa.
Mental illness
Late 1800s: The expectation in the United States that hospitals for the mentally ill and humane treatment will cure the sick does not prove true. State mental hospitals become over-crowded, and custodial care supersedes humane treatment. New York World reporter Nellie Bly poses as a mentally ill person to become an inmate at an asylum. Her reports from inside result in more funding to improve conditions.
Cancer
1889: William Halsted develops the radical mastectomy to treat breast cancer; the technique includes the surgical removal of the tumor, breast, overlying skin and muscle.
Surgery and medical technology
1890s: Chemical agents are used to minimize germs. Carbolic acid is put on incisions to minimize germs and decrease infection rates.
Cancer
1895: Wilhelm Conrad Roentgen invents X-rays. Radiation therapy follows.
Surgery and medical technology
1895: The first X-ray is performed in Germany.

1900s

Mental illness
Early 1900s: The primary treatments of neurotic mental disorders, and sometimes psychosis, are psychoanalytical therapies (“talking cures”) developed by Sigmund Freud and others, such as Carl Jung.
Immunization and disease prevention
1914: Typhoid and rabies vaccine are first licensed in the U.S.; tetanus toxoid is introduced.
Immunization and disease prevention
1915: Pertussis vaccine is licensed.
Immunization and disease prevention
1918: The Spanish influenza pandemic is responsible for 25 million to 50 million deaths worldwide, including more than 500,000 in the U.S.
Cancer
1919: A chemical in the mustard gas used during World War I is found to reduce white blood cells. Chemotherapy is born.
Surgery and medical technology
1922: Insulin is first used for treatment of diabetes, allowing diabetics to survive after diagnosis.
Surgery and medical technology
1928: Antibiotics dramatically decrease post-surgical infections.
Mental illness
1930s: Drugs, electro-convulsive therapy, and surgery are used to treat people with schizophrenia and others with persistent mental illnesses. Some are infected with malaria; others are treated with repeated insulin-induced comas. Others have parts of their brain removed through lobotomies.
Surgery and medical technology
1937: The first blood bank opens, helping make more surgery possible by treating bleeding during the procedure.
Immunization and disease prevention
1943: Penicillin becomes mass-produced.
Mental illness
1946: President Harry Truman signs the National Mental Health Act, calling for the National Institute of Mental Health to conduct research into the brain and behavior and reduce mental illness.
Cancer
1947: Chemotherapy records its first, though temporary, success with the remission of a pediatric leukemia patient.
Mental illness
1949: Australian psychiatrist J. F. J. Cade introduces the use of lithium to treat psychosis. Lithium gains wide usage in the mid-1960s to treat those with manic depression, now known as bipolar disorder.
Surgery and medical technology
1950: John Hopps invents the cardiac pacemaker.
Cancer
1950s: Findings related to DNA give rise to molecular biology.
Mental illness
1950s: A series of successful anti-psychotic drugs are introduced that do not cure psychosis but control its symptoms. The first of the anti-psychotics, the major class of drug used to treat psychosis, is discovered in France in 1952 and is named chlorpromazine (Thorazine). Studies show that 70 percent of patients with schizophrenia clearly improve on anti-psychotic drugs.
Mental illness
1950s: A new type of therapy, behavior therapy, suggests that people with phobias can be trained to overcome them.
Surgery and medical technology
1953: A heart-lung bypass machine is used successfully for the first time.
Immunization and disease prevention
1955: The first polio vaccine is licensed, pioneered by Dr. Jonas Salk. The Polio Vaccination Assistance Act is enacted by Congress, the first federal involvement in immunization activities.
Surgery and medical technology
1957: William Grey Walter invents the brain EEG topography (toposcope).
Cancer
1964: A U.S. surgeon general’s report establishes an undeniable link between smoking and cancer.
Mental illness
Mid-1960s: Many seriously mentally ill people are removed from institutions. In the United States they are directed toward local mental health homes and facilities. The number of institutionalized mentally ill people in the United States will drop from a peak of 560,000 to just over 130,000 in 1980. Many people suffering from mental illness become homeless because of inadequate housing and follow-up care.
Immunization and disease prevention
1966: The Centers for Disease Control and Prevention announces the first national measles eradication campaign. Within 2 years, measles incidence decrease by more than 90% compared with prevaccine-era levels.
Surgery and medical technology
1967: A heart transplant is performed by South African physician Christian Barnard. The heart recipient survived 18 days until succumbing to pneumonia.
Cancer
1971: President Richard M. Nixon signs the National Cancer Act.
Cancer
1972: The development of computed tomography (CT) revolutionizes radiology.
Cancer
1973: Dr. Janet Rowley shows chromosome abnormalities in those with cancer.
Surgery and medical technology
1978: A baby conceived via in-vitro fertilization is born.
Mental illness
1980s: An estimated one-third of all homeless people are considered seriously mentally ill, the vast majority of them suffering from schizophrenia.
Cancer
1981: FDA approves the first vaccine against hepatitis B, one of the primary causes of liver cancer.
Surgery and medical technology
1982: The Jarvik-7 artificial heart is used.
Surgery and medical technology
1985: The first documented robotic surgery is performed.
Mental illness
1986: Prozac is developed to treat various mental illnesses.
Cancer
Early 1990s: For the first time, overall cancer death rates begin to fall.
Mental illness
1990s: A new generation of anti-psychotic drugs is introduced. These drugs prove to be more effective in treating schizophrenia and have fewer side effects.
Immunization and disease prevention
1994: The entire Western Hemisphere is certified as “polio-free” by the World Health Organization.

2000s

Surgery and medical technology
2000: Robotic surgical systems win U.S. Food and Drug Administration approval.
Cancer
2001: The FDA approves Gleevec, the first drug to target a specific gene mutation.
Surgery and medical technology
2003: The sequence of a complete human genome is published.
Immunization and disease prevention
2006: A vaccine is developed to prevent cervical cancer due to human papillomavirus.
Immunization and disease prevention
2009: The vaccine court rules that the mumps/measles/rubella vaccine, when administered with thimerosal-containing vaccines, does not cause autism.

Source: Best Medical Degrees 

Topics: history, change, evolution of medicine

The Role of a Certified Nurse-Midwife

Posted by Alycia Sullivan

Wed, Apr 02, 2014 @ 01:30 PM

JnymzEi resized 600

Topics: jobs, midwife, CNM, nurse, infographic, salary

REAL advice on stress relief for nurses

Posted by Alycia Sullivan

Mon, Mar 24, 2014 @ 02:25 PM

BY 

 

Stress Relief 298x185We all have moments in which the stress of our jobs threatens to make our heads spin around 360 degrees. Moments like that are fine, but if there’s a trend toward constant head-spinning, then you, my friend, need an intervention. 

Tip One: Make sure your personal space is as stress-free as possible.
When you come home at night or in the morning, are you faced with stacks of dishes in the sink and cat hair everywhere? You need to start taking care of that stuff on your days off. Your home is a haven. Even with roommates or kids, you can have one space that’s inviolable and neat and clean. That one thing will make such a difference in your mental health, it’s amazing.

Tip Two: Treat your body well.
Fast food is good once in a while, but for tip-top functioning, you really need to pay attention to how you feed your body. Good, clean food will help your body and brain work well and will lessen your stress levels immensely. Batch-cooking things you can stand to eat during and after your shifts will make you so much happier than a burger from Big Bob’s Burger Barn.

Tip Three: Simplify.
I have six of the exact same uniform, four bras that I know fit perfectly and eight pairs of socks that are identical. I have a zippered makeup bag that I got for a buck at Target that holds all my work stuff, from pens to stethoscope to ID. I have set jewelry to wear to work, and a set time in the morning by which certain things have to be accomplished. This makes my life so much easier, I can’t even tell you.

Integral to this plan is a coffeemaker with a timer. If you don’t own one, go get one.

Tip Four: Know which stress relievers are good in the long run.
I’m a big fan of carefully applied general anesthetic in the form of ETOH (as my mother says), but not after every shift. A glass of wine or other Adult Beverage of your choice can be helpful when you’re too wound up to sleep or if your brain simply won’t shut up…but don’t make a habit of it. Exercise is better (and I’ve never found that getting good and sweaty an hour before bed will make me insomniac), venting to a friend is good (especially if she’s not also a nurse), playing catch with your pup or the neighbor’s kids can work. Know what’s healthy (movement, talk, art, music) and what’s not (alcohol, too much food, drugs), and plan accordingly.

Tip Five: Get a massage. Seriously.
Touch is amazing for making you feel better. Find yourself a good massage therapist and get the two-hour rubdown. Don’t plan anything at all for the rest of the day. You’d be amazed at how small niggling problems and constant stressors seem when you can barely walk to the car. If you can afford it, do it once or twice a month: It’ll give you something to look forward to, and you’ll feel amazing for at least a day or so.

Source: Scrubs Mag 

Topics: wellness, relaxation, work vs home, relief, stress

Rise of the Nurse Practitioner

Posted by Alycia Sullivan

Fri, Mar 21, 2014 @ 12:33 PM

TheRiseoftheNursePractitioner 2 27 resized 600

TheRiseoftheNursePractitioner 2 27 resized 600Source: Maryville University 

Topics: growth, education, nursing, online, nurse practitioner

Nurses on the run

Posted by Alycia Sullivan

Mon, Mar 17, 2014 @ 01:43 PM

For nearly a year, the Boston Marathon bombings and their aftermath have haunted Chelsey McGinn, RN, of the Blake 12 Intensive Care Unit (ICU). In December the MGH gave McGinn an opportunity to honor the victims – and begin her own healing process – by running this year’s marathon as part of its Emergency Response Fund team.

“I feel like it’s been almost a year now, and I haven’t really done anything therapeutic sinceBlake12Marathoners resized 600 it happened,” McGinn says. “I felt like other people who I worked with found ways to kind of cope with it, but I hadn’t really found that. When this came up, I thought this was a perfect way to celebrate how far the victims have come and recognize my co-workers.” 

McGinn is one of six nurses on her unit who are planning to run the 2014 Boston Marathon – five for charity teams and one as a qualified runner. Most are first-time runners, and all say they are running in honor of the three bombing victims who were treated on the unit.

“I had a really hard time afterward, and it lasted longer than I expected,” says Laura Lux, RN, who is running for the American Red Cross. “I’m running because I don’t want to be defeated. I know if he could, my patient would be running just to prove a point. Because he can’t, I feel like I need to do this for him. After watching what he and his family went through, I feel like it’s the least I could do for them.”

Lux says she felt an immediate connection with her patient and his family. “Despite everything they were just so determined and so strong,” she says. “Everyone was angry, but there was good coming from it too. We got to know each other because of it. I felt like he was a family member. It’s the most personal experience of my career.”

Lux’s experience is similar to that of the other nurses who are running, including Emily Erhardt, RN, a trauma ICU nurse and member of the MGH Emergency Response Fund Team, who has stayed in touch with her patient and his family since they left the hospital. “This event affected everyone, so it was one of the few times in my career that I felt like all I could do with the family was cry with them. It’s such a terrible thing that happened that there aren’t words to comfort them. You just have to be there for them,” she says. “A year ago they were strangers to me, but now they’re the most inspiring people in my life. I’m not much of an athlete, but I was really affected by the whole thing, and I wanted to do something more.”

describe the image

Blake 12 runners receive a boost of support from the Harvard University Employees Credit Union. Included in the photo with members of the ICU are Paul Conners, MGH branch manager; Eugene Foley, president and CEO; and Guillermo Banchiere, MGH director of Environmental Services, who serves as a member of the credit union's board of directors.

Allyson Mendonza, RN, who is running for the Mass General Marathon Team “Fighting Kids Cancer … One Step At a Time,” recalls the moment she knew she too wanted to do something more. Mendonza says her patient had just returned from surgery when she was told President Barack Obama was coming to visit. The woman was excited but was distraught about her appearance, so Mendonza and her colleague soaked her nails and helped shampoo and condition her hair to wash out the cement and clumps of dried blood.

“We just tried our best to make her feel better about herself and feel good for the day ahead. She actually fell asleep. When she awoke, she said, ‘This is the most relaxed I have felt in days.’ It was just so emotional for us and for her,” Mendonza says.

Caring for the marathon victims brought the unit closer together, and staff once again have come together to support and encourage their fellow colleagues.

“The teamwork and the camaraderie were amazing,” saysKatherine Pyrek, RN, who was the charge nurse during the week of the bombing. “Every one of the nurses was affected by what was going on, but they stayed strong and carried on. The bonds the nurses made with the patients and their families were incredible and really went above and beyond.”

Pyrek, who is running for the Mass General Marathon Team, says the Blake 12 runners offer each other advice and encouragement to help in the training process. “We remind why we’re doing this – for our patients and their families,” she says. “I think about the patients when they were in pain and how scared they were. I think that if they get through it then I can get through however many miles I need to run.”

 

The runners all say they look to Meredith Salony, RN, a veteran marathoner who qualified for the marathon, for guidance. “I’m so proud to be in this unit where there’s so much enthusiasm. Even the people who aren’t running are trying to help out and organize events and find ways for people to contribute,” Salony says.

Each of the nurses says they are overwhelmed when they imagine how they will feel on Marathon Monday.

“I think it’ll be really therapeutic and empowering,” McGinn says. “I’m honored to be a part of it. If I’m ever going to run a marathon, this is the one I want to run. I’ll always remember the way I felt at work that night, and it’s going to be a really nice thing to be able to remember this feeling for the rest of my life too.”

For more information or to support the teams visit www.runformgh.org.

This is the first in a series of articles that MGH Hotline will publish about staff running in this year’s Boston Marathon.

Source: Massachusetts General Hospital

Topics: nurses, patients, Boston Marathon, Massachusetts General Hospital, Run for MGH

Nurses and Facebook: What You Need to Know

Posted by Alycia Sullivan

Mon, Mar 17, 2014 @ 12:24 PM

by Danielle Logacho

Let’s say you’re a nurse at a local hospital. For the past several weeks, you’ve been for afacebook resized 600 young boy who needs a heart transplant.

One day, you learn that a donor organ has become available. You are elated – and you decide to share the news on your Facebook page.

“Great news! A new heart has been found for my five-year-old patient at Children’s. Be brave, Aiden – we’re all rooting for you!”

Good idea? Not really.

That’s because a post like this – while well intentioned – is a breach of confidentiality. There’s enough information here to identify the patient, his condition and the hospital where he is receiving treatment. Put it all together, and you’ve got yourself a HIPAA violation.

The truth is, there can be real consequences to nurses’ irresponsible use of social media. State boards of nursing may investigate reports of inappropriate disclosures on Facebook and other social media sites. If the allegations are found to be true, nurses can face reprimands, sanctions, fines, or temporary or permanent loss of their nursing license.

Many organizations have social media policies that govern employees’ use of social media, even if it’s for personal purposes. If yours is one of them, be sure to read and understand the guidelines.

Even if your employer does not have a specific policy, the main rule of thumb should be familiar to you: as a nurse, you have the legal and ethical obligation to maintain patient privacy and confidentiality. 

The Health Insurance Portability and Accountability Act (HIPAA) specifically defines “identifiable information” and when and how it can be used. Such identifiable information could cover the past, present or future health of a patient, or it could be something that would lead someone to believe that it could be used to identify a patient.  Brush up on your understanding of HIPAA.

How do you avoid problems? Do you need to stop using Facebook altogether if you’re a nurse? No, but you do need to be careful. Here are a few general guidelines:

- Simply put: Don’t reveal any personal health information about your patients in your posts. (And don’t think that it’s OK if you reveal their details but give them a fake name.)

- Don’t post any photos of your patients, even if they are cute kids. Photos are specifically called out in HIPAA as identifiable information.

- Maintain professional boundaries, even online. Friending your patients or patients’ families is, in most cases, a no-no. The Mayo Clinic’s guidelines for employees say, “Staff in patient care roles generally should not initiate or accept friend requests except in unusual circumstances such as the situation where an in-person friendship pre-dates the treatment relationship.”

- Don’t rely on privacy settings. No matter how meticulous you are about privacy settings, there’s no guarantee that a friend won’t like your post so much that she takes a screenshot and posts your “private” message elsewhere.

- Remember that anything online will be there forever, even if you delete it. Someone may have taken a screenshot before you took your post down. If you are under investigation, your posts can be still found on servers.

For more information, read A Nurse’s Guide to the Use of Social Media from the National Council of State Boards of Nursing.

 

These guidelines are for informational purposes only and are not legal advice.

 

References

National Council of State Boards of Nursing. (2011). A Nurse’s Guide to the Use of Social Media [Brochure]. Retrieved from https://www.ncsbn.org/NCSBN_SocialMedia.pdf

Pagana, K. (2014, January 21). Facebook: Know the Policy Before Posting [Webinar]. In Nurse.com Continuing Education series. Retrieved from http://ce.nurse.com/course/ce630/facebook/.

Source: Chamberlain College of Nursing 

Topics: nursing, social media, Facebook, HIPPA, caution

Lost in Clinical Translation

Posted by Alycia Sullivan

Wed, Mar 05, 2014 @ 11:01 AM

A classic “Far Side” cartoon shows a man talking forcefully to his dog. The man says: “Okay, Ginger! I’ve had it! You stay out of the garbage!” But the dog hears only: “Blah blah Ginger blah blah blah blah blah blah blah blah Ginger …”

As a nurse, I often worry that patients’ comprehension of doctors and nurses is equally limited — except what the patient hears from us is: “Blah blah blah Heart Attack blah blah blah Cancer.”

I first witnessed one of these lost-in-translation moments as a nursing student. My patient, a single woman, a flight attendant in her early 30s, had developed chest pain and severe shortness of breath during the final leg of a flight. She thought she was having a heart attack, but it turned out to be a pulmonary embolism: a blood clot in the lungs. Treatment required several days in the hospital. Already far from home and alone, she was very worried that a clotting problem would mean she could no longer fly.

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When the medical team came to her room, they discussed her situation in detail: the problem itself, the necessary course of anti-coagulation treatment and the required blood tests that went with it. To me, just at the start of my nursing education, the explanations were clear and easy to follow, and I felt hopeful they would give my patient some comfort.

After the rounding team left, though, she turned a stricken face to me and deadpanned, “Well, that was clear as mud, wasn’t it?”

I sat down and clarified as best I could. But until then, I hadn’t realized what a huge comprehension gap often exists between what we in health care say to patients and what those patients actually understand.

A growing body of literature suggests that these clinical miscommunications matter, because the success of physician-patient interaction has a real effect on patients’ health.

In a 2005 article in the Journal of the American Medical Association, Eric B. Larson and Xin Yao, researchers at the University of Washington, claim that treatment outcomes are better when doctors show more empathy and take the time to make sure patients understand what’s going on.

I saw the importance of caring communication during a friend’s recent heart attack scare. He had a lingering case of bronchitis, and one morning found himself struggling for air. He had pain in his shoulders, back and neck and a feeling of increasing constriction in his chest.

Concerned, his wife took him to the emergency room, where his breathing became even more labored. In the triage area he began sweating profusely and then collapsed. A rapid response team rushed in, put him on oxygen, started an IV, got an EKG. His wife thought she was watching, helplessly, as her husband of more than 20 years died in front of her.

Minutes passed and the code team revived him, but no one told her that he’d passed out because of a protective effect of his autonomic nervous system, not because his life was threatened. No one fully explained that to him, either.

At that point his wife called me, and knowing how confusing modern health care can be, I went to the hospital to help. I caught up with them in the cardiac catheterization lab, where the miscommunications continued. The cardiac cath showed that his arteries were clear — but the diagnosis, explained in technical terms, meant nothing to his wife. It took over 12 hours to learn that his echocardiogram revealed all cardiac structures to be normal. (Also, no one told the wife that her husband would stay overnight in the I.C.U. because protocol required it, not because he actually needed intensive care.)

Although my friend received exemplary care, neither he nor his wife felt that they had. Instead, similar to my patient in nursing school, they felt they had been hijacked to a foreign land. The hospital staff members were obviously dedicated to restoring patients’ health, but they and the work itself came across as alien, obtrusive and impossible to understand. Also, my friend’s problem was correctly diagnosed days later when he went to his primary care physician. Acid reflux was causing his pain; the cure was a prescription for Prilosec.

Interestingly, patients in hospitals report more satisfying interactions with physicians when doctors sit down during rounds instead of standing, according to a 2012 article co-written by the researcher Kelli J. Swayden, a nurse practitioner, in the journal Patient Education and Counseling. Sitting gives the message “I have time,” whereas doctors who stand communicate urgency and impatience.

I don’t mean to blame doctors and nurses; it can be very hard to force yourself to slow down and tune in to a patient’s wavelength when you have other patients and countless pressing tasks to get to.

And that’s especially true today, when hospitals are focused, machinelike, on volume and flow. Bedside manner does not increase efficiency, and it certainly can’t be charged for. Still: My friends had gone from blueberry pancakes at breakfast to worrying that the husband might die, and the closest anyone got to assuaging that fear was the doctor who said, “Well, we’ve ruled out everything that will kill you right away.”

And that’s not good enough, because going to the hospital is an exercise in trust. Ill health is frightening, the treatments we offer can be scary, and stress and anxiety make people poor listeners. Our high-tech scans and fast-paced care save lives, but we need to make time for the human issues that pull at every patient’s heart.

Theresa Brown is an oncology nurse and the author of “Critical Care: A New Nurse Faces Death, Life, and Everything in Between.”

Source: New York Times Opinionator

Topics: BEDSIDE, LANGUAGE AND LANGUAGES, MEDICINE AND HEALTH, doctors, hospitals, NURSING AND NURSES

NIH study seeks to improve asthma therapy for African-Americans

Posted by Alycia Sullivan

Wed, Mar 05, 2014 @ 10:56 AM

By National Institute of Health

Researchers will enroll around 500 African-American children and adults who have asthma in a multi-center clinical trial to assess how they react to therapies and to explore the role of genetics in determining the response to asthma treatment. This new clinical study, which will take place at 30 sites in 14 states, is aimed at understanding the best approach to asthma management in African-Americans, who suffer much higher rates of serious asthma attacks, hospitalizations, and asthma-related deaths than whites.

The Best African American Response to Asthma Drugs (BARD) study is under the auspices of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.

“This large-scale clinical effort is expected to provide new insights into how health care professionals can better manage asthma in African-Americans to improve outcomes,” said Gary H. Gibbons, M.D., director of the NHLBI.

“BARD reinforces the institute’s commitment to understand, reduce, and ultimately even eliminate the disparities in asthma outcomes observed in the African-American population compared to other Americans with asthma,” added James Kiley, M.D., director of the NHLBI Division of Lung Diseases.

BARD will examine the effectiveness of different doses of inhaled corticosteroids (ICS) used with or without the addition of a long-acting beta agonist (LABA). ICS reduce inflammation and help control asthma in the long term. LABAs relax tight airway muscles. This study will compare multiple combinations of medications and dosing regimens to assess the response to therapy. BARD will track whether children and adults respond similarly to the same treatment, and evaluate how genes may affect treatment response.

“While national asthma guidelines provide recommendations for all patients with asthma, it is possible that, compared with other groups, African-Americans respond differently to asthma medications,” said Michael Wechsler, M.D., principal investigator for the BARD study and professor of medicine at National Jewish Health in Denver. “Our study is designed to specifically address how asthma should be managed in African-American asthma patients, both adults and children.”

The BARD study is supported by NHLBI’s AsthmaNet clinical trials network. BARD began enrolling patients on Feb. 10.

To schedule an interview with an NHLBI spokesperson, please contact the NHLBI Office of Communications at 301-496-4236 or nhlbi_news@nhlbi.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Topics: therapy, African Americans, asthma, BARD, NIH

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