Strictly Clinical

‘Tis the season…to immunize

For many nurses, August is a whirlwind of back-to-school activity. And it’s not just the crunch of shopping for school supplies, new clothes, or that elusive trendy lunch…
influenza zoster vaccines

2009 H1N1 Flu – Situation Update

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week…

2009 H1N1 Flu – Situation Update (01.04.10)

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week…

2009 H1N1 Flu – Situation Update (01.08.10)

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week…

2009 H1N1 Flu – Situation Update (11.20.09)

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView.* During the week…

2009 H1N1 Flu – Situation Update (12.04.09)

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week…

2009 H1N1 Flu – Situation Update (12.11.09)

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week…

A little humor please

Laughter is a way of dealing with life’s stressors. Learning how to use humor to enrich our personal and professional lives can benefit us in our roles as…

A new oral anticoagulant hits the market

Pradaxa gives clinicians a new tool for preventing strokes and blood clots in patients with atrial fibrillation. Learn how it works, who’s eligible to receive it, and how…

A quantum life

Quantum theory explains how you create your life through what you choose to think, then intend and, ultimately, do.

A stubborn case of supraventricular tachycardia

JAKE KARCHNER, age 65, is admitted for treatment of acute myeloid leukemia. Because of his history of supraventricular tachycardia (SVT), the physician has ordered telemetry monitoring. When you…

A troubled life, a difficult death

Editor’s note: National Homelessness Awareness Week is November 10-18. Like many of our homeless patients, “Sarah” was a bundle of contradictions. She came from money, got a good…

A woman’s worst enemy

Most women woefully underestimate their risk for heart disease. Although breast cancer gets more publicity, heart disease and stroke kill nearly 12 times as many American women. This…

AACN endorses white paper on medication reconciliation

The American Association of Critical-Care Nurses (AACN) recently endorsed a white paper that calls for system-wide programs for medication reconciliation — the process of verifying that current patient…
abdominal aortic aneurysm

Abdominal aortic aneurysm

Recognize potential danger for a positive outcome. Takeaways:  Abdominal aortic aneurysm is a serious condition that requires prompt identification and effective interventions.  Early recognition of abdominal aortic aneurysm…
absolute neutrophil count (anc)

Absolute Neutrophil Count

For a patient with cancer, the absolute neutrophil count (ANC) is a crucial lab value. Are you familiar with the two methods for calculating it?

Act fast against anaphylaxis

Anaphylaxis can kill within minutes unless the victim receives immediate treatment. Calling a rapid response team to the scene can avert disaster.

Acts of kindness

Many of us have lasting memories of a few special patients. For me, Joe is one of those patients. The day he was admitted, Joe was one of…
Acute cardiac tamponade

Acute cardiac tamponade

Martin Pace, a 65-year-old man, is admitted with an inferior wall ST-segment elevation myocardial infarction and receives a permanent pacemaker for sick sinus syndrome. When he returns to…

Acute cardiogenic pulmonary edema

RONALD BARRETT* is admitted to the medical telemetry unit after arriving in the ED after 2 days of nocturnal dyspnea and mild chest pressure. Mr. Barrett, who’s 68…

Acute flaccid myelitis

Nursing implications and public health Takeaways:  Acute flaccid myelitis (AFM) is a perplexing condition which, to date, has no concrete effective treatment. The Centers for Disease Control and…
Acute hypopituitarism, healthcare, registered nurse, nursing, nursing journal

Acute hypopituitarism

Your recognition of troubling signs and symptoms results in prompt diagnosis and treatment. Takeaways: Hypopituitarism is the deficient secretion of one or more pituitary hormones. The most common…

Adult intussusception

Quick action ensures prompt diagnosis and treatment. Takeaways: Metformin-associated induced lactic acidosis (MALA) is a life-threatening condition that requires prompt, aggressive management. Early recognition of signs and symptoms…

Adult migraine: More than a headache

Migraine is a debilitating condition that alters the lives of many people worldwide. Migraine frequently goes misdiagnosed, underdiagnosed, and undertreated. Nurses play an important role in assessing for…

Advances in blood transfusion

Ongoing research, development, and vigilance initiatives are designed to make blood components safer and more easily available.

Adventures in virtual meetings

Tired of unproductive staff meetings held at inconvenient times? Had it  up to here with being interrupted when trying to express your opinion? Maybe it’s time to explore…
Amniotic fluid embolus

Amniotic fluid embolus

Immediate treatment to optimize hemodynamic function, cardiac output, respiratory support, combined with aggressive management of volume and coagulopathy, enhances maternal outcome.
ALS

Amyotrophic lateral sclerosis and the trajectory of care

Amyotrophic lateral sclerosis (ALS), a progressive neurodegenerative disease whose pathophysiology isn’t understood, results in upper and lower motor neuron dysfunction. This neural damage leads to muscular atrophy, spasms,…

An invitation to error

What happens when you’re short staffed and there isn’t anyone to help?
nusre-health-safety

ANA advocates for nurses’ health and safety

Collaborating in the new year to address pandemic challenges together As nurses contend with the pandemic and its multi-layered effects into 2021, the American Nurses Association (ANA) continues…

ANA comments on ACOs

In the political realm, there is intense debate on how to cut costs in the Medicare program without sacrificing services or care to beneficiaries. An interesting note that…

ANA endorses Kid Safe Chemicals Act

Acting on a directive from the 2006 House of Delegates, ANA has endorsed the Kid Safe Chemicals Act. The bill would ensure for the first time that all…

ANA Immunize resource

Click to visit www.anaimmunize.org, the American Nurses Association’s online immunization resource.

ANA works to remove legal barriers to APRN practice

While advanced practice registered nurses (APRNs) have been increasing in number and expanding their impact on the healthcare system, federal law continues to contain many barriers to full…
Anaphylasxis_schoolnurse

Anaphylaxis in the school setting

School mealtimes are important for socialization and nutrition, but food allergies can be life-threatening. Quick assessment and action by school nurses are essential to help students in distress.…

Anatomy lesson 101

ANA’s National Center for Nursing Quality promotes nursing quality and patient safety while helping nurses advocate for themselves.
AnimalAssistants

Animal assistants in healthcare

An animal may provide just the benefit patients need. Prepandemic, I had the pleasure of traveling to the National Institutes of Health (NIH) for a month-long workshop. I…

Antibiotic stewardship

ANTIBIOTIC resistance is a growing global threat that goes beyond methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci, and other familiar multidrug-resistant (MDR) pathogens. In fact, MDR organisms (those resistant…
Aphasia

Aphasia: When speaking is hard

Imagine you are talking, and then suddenly you can’t. Your ability to communicate has paused. Over time, or in an instant, your ability to communicate and life as…

Are 12-hour shifts safe?

Is working 12 consecutive hours in a fast-paced, high stress, physically and mentally demanding environment a good idea? Click here to read this exciting blog posting.

Are you an ABG ace?

Can you interpret arterial blood gas (ABG) values with confidence? To find out, test yourself with the case studies in this article.

Are you prepared for malaria?

Global traveling brings about 1,000 cases of malaria to this country each year. Don’t be caught off guard if you encounter it in your practice.

Astute assessment prevents paralysis

What seems like a simple pulled muscle to a shipping clerk turns out to be cauda equina syndrome, a potentially paralyzing injury that warrants immediate surgery.

Asymptomatic bacteriuria in institutionalized elderly

Antibiotic stewardship has gained much awareness, but inappropriate prescribing of these medications continues. For example, many patients, caregivers, and clinicians associate urinary tract infection (UTI) with falls, confusion,…

Attitude: The power of human energy

Our thoughts, feelings, and disposition influence other people, not just because people see and read our facial expressions or body language, but because thoughts themselves are energy.

Autonomic dysreflexia in spinal cord injuries

Patients with a spinal cord injury frequently endure multiple challenges stemming from their injuries—including issues related to breathing, skin breakdown, sexual activity, and bowel and bladder dysfunction—which can…

AWHONN releases new staffing guidelines

The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) recently announced that it has published new perinatal nurse staffing guidelines to reflect the demands of providing care…

Battlefield nursing at the Boston Marathon

Three yellow balloons danced through the air, hovering over the finish line after being released by the bomb blast that brought the 2013 Boston Marathon to a catastrophic…

Being with Dying

Your most powerful message has nothing to do with words.
climate

Best practices for seasonal influenza immunization

Seasonal influenza and influenza-related complications are the most frequent causes of death from a vaccine preventable disease in the United States. In 2006, the February 24 Morbidity and…
gift patient gratitude thanks acceptance

Beyond a box of chocolates

Often, patients and families express their gratitude for a special nurse’s outstanding care with spoken thanks or heartfelt commendations written to a nursing supervisor. Some even offer a…

Beyond customer service

Many nurses don’t like to hear their patients called “customers” or be told to provide “customer service.” This expert explains how to lose the lingo and adapt the…

Blood-borne pathogen exposure injuries

Healthcare workers are exposed to blood-borne pathogens through contaminated needlesticks, sharps injuries, and mucous membrane exposures to infectious blood or body fluids of patients. The Centers for Disease…
bradykinin induced angioedema

Bradykinin-induced angioedema

Quick treatment results in a good outcome. Takeaways: Angiotensin-converting enzyme inhibitors can increase the release of bradykinin, which can increase tissue permeability with dilatation of the vessels and…

Breath at the belly

Mindfulness training can help nurses, patients, and loved ones cope with loss, grief, and suffering.

Brought to you by NDNQI: Data that do good

Thanks to the National Database of Nursing Quality Indicators, hospitals and nurses are capturing and converting into data what nurses actually do and how their actions affect patient…

Building the case for chemical policy reform

Over the past three decades, we have become increasingly aware of the impact that our environment, and chemical exposures in particular, has on our nation’s health. We know…

Calculating and interpreting the odds ratio

Researchers use the odds ratio to analyze which of two groups of individuals is more likely to have an adverse outcome. Find out how to calculate the odds…

Calculating I.V. drip rates with confidence

Do you sometimes have trouble remembering the equation you learned for calculating I.V. drip rates? This article presents a simplified equation that can make calculations quicker and easier…

Calming a thyroid storm

Saving a patient’s life may rest on recognizing which findings are red herrings and which hold the key to the crisis.
elder nurse old age

Can a nurse be too old to work at the bedside?

Read guest blogger Donna Cardillo’s thought-provoking article about when age comes into play during a nurse’s career. A recent New York Times article begged the question, “How old…

Care during crisis

ANA brings nurses, experts together to shape practice policy during disasters

Care, not chaos

A new document created by ANA and other groups delineates emergency care principles for psychiatric patients.

Caring and advocating for school children

When we think about RN staffing issues, most of us immediately think about these issues in the context of hospitals or long-term care facilities. There is another, less…
obesity

Caring for adult patients with obesity in primary care

Obesity is a complicated chronic disease with many contributing and interrelated factors that include genetics, biology, metabolism, and neurobehavior. It’s also affected by society, the economy, and culture.

Carrots and sticks

The Stick—penalties for excess readmissions Is your hospital on the list? Starting this month, over 2,200 hospitals are forfeiting up to 1% of their base Medicare payments as…

Cartoonist with a cause

The cartoons of Theresa Garnero, APRN, BC-ADM, MSN, CED, help patients cope with diabetes.

Case study: Coerced consent

“Coercion is commonly said to invalidate consent, and that is always true if the source of the coercion is the physician.

Case Study: How much is enough?

Three-year-old Christy* has been in the hospital’s pediatric intensive care unit (PICU) since birth, when she was diagnosed with McCune-Albright syndrome and multiple other conditions that left her…
cauda equina

Catching cauda equina in time

Michael Smith, age 45, is admitted for lumbar laminectomy revision and fusion surgery. Despite his operative blood loss of an estimated 800 mL, he’s recovering uneventfully in the…

Catching on to C. difficle

Typically caused by antibiotic therapy, Clostridium difficile is now common in hospitals. Learn how to help stop the spread of this potentially fatal infection.
Cerebral Vasospasm

Cerebral vasospasm

Prompt recognition of subtle signs saves patient’s life. Key Points: Patients who experience an aneurysmal subarachnoid hemorrhage (aSAH) require frequent neurologic assessments to monitor for vasospasm. Vasospasm occurs…

Challenging nursing’s sacred cows

Do you routinely instill normal saline solution into endotracheal tubes before suctioning? Use only the Glasgow Coma Scale for neurologic assessment? Evidence on these and other sacred cows…

Chemical soup

ANA and state associations work to protect nurses and the environment from chemicals.

Chylothorax: A stepwise approach to care

Clinical management of chylothorax varies, so implementing an organized stepwise approach to care can improve patient outcomes. Components of this approach include a thorough evaluation of the patient’s…

Clinical trials 101

Don’t miss the second in a four-part series on clinical trials written by nurses from the National Cancer Institute at the National Institutes of Health, which covers phases…

Closing in on the cause of agitation

Leonard McGram, age 89, arrives at the emergency department (ED) with Marissa, his daughter. As you help him out of her car, he looks at her and asks,…

Color awareness: A must for patient assessment

Color “blindness” may help minimize social and economic disparities, but can impede accurate patient assessment. The author explains why nurses should practice color awareness and tells how to…

Coloring outside the lines

The Institute of Medicine’s Future of Nursing Initiative needs to create solutions that propel nursing and health care into the future.

Connecting the dots leads to suspicion of sepsis

Maria Espinoza, age 45, is recovering on the medical-surgical unit 2 days after a decompression fasciotomy for compartment syndrome of her right thigh, following a quadriceps muscle tear…

Cornucopia

Food-and Americas’ overconsumption of it-have become public health issues. We need therapy for what one expert calls our “national eating disorder.”
covid 19 diagnostic testing

COVID-19 diagnostic testing

Nurse knowledge can improve test administration, ensure efficacy, and increase result accuracy Takeaways: • Three COVID-19 diagnostic testing methods are available: molecular, antigen, and antibody. • Each method…

COVID-19 skin manifestations

Distinguishing between COVID-19 skin manifestations and DTI aids identification, reimbursement, and treatment.

Creating a smooth move for patients and staff

When Missouri Baptist Medical Center had to relocate nearly 200 patients in a single day, staff and leaders knew collaboration and planning would be key. Here’s how they…

Cystocerebral syndrome

JOHN MCDONALD* is a 72-year-old man with a history of stage III small cell lung cancer, smoking, hyperlipidemia, benign prostatic hyperplasia (BPH), and constipation. A week after his…

Dear Members of Congress

In an open letter to Congress, Dr. Cipriano urges legislators to leverage nurses’ knowledge, skills, and abilities to help bring order to a chaotic healthcare system.

Déjà vu all over again

Some people simply can’t learn from the past—even the fairly recent and painful past.

Delegating without doubts

With this decision tree as your guide, you’ll delegate tasks to assistive personnel with confidence.
dementia quiet thief nurse forgetful

Dementia: The quiet thief

The nurse’s note read, “not orientated to place and time due to dementia.” Several hours of general anesthesia for a knee replacement and then morphine via a patient-controlled…
demystifying palliative hospice care ant

Demystifying palliative and hospice care

Armed with answers, you can provide patients and families with the information they need to make care decisions. Takeaways: Patients and their families may not understand the difference…
denture-care-promotes-good-health

Denture care promotes good health

Oral secretions and dental plaque consist of many pathogenic and non-pathogenic bacteria and fungi. Microbial plaque that accumulates on dentures may be harmful to both the oral mucosa…

Derailing potentially deadly dehydration

When a dehydrated patient falls into a stupor and her vital signs head south, a rapid response team can help unit nurses stabilize her quickly – and avoid…

Detecting cardiac injury with telemetry

With multi-lead telemetry monitoring, a nurse detects dangerous changes in her patient’s heart rhythm, permitting quick action before an acute MI does permanent damage.

Detecting dysphagia

It’s 8:00 am and time for your 83-year-old patient, Virginia Johnson*, to take her oral medication. She was admitted with a left femoral fracture following a fall. After…

Diabetes innovations and access to care

Over the years, several innovations (insulin, glucometers, insulin pens) have helped to improve diabetes care and management. However, many of these technologies remain out of reach for some…

Dispelling pain myths

Read up on the latest evidence-based best practices in pain management.

Dodging a trach tragedy

When a patient’s O2 Sat falls and subcutaneous neck edema arises, adroit troubleshooting identifies the cause.

Does your workplace culture need CPR?

If you suspect your workplace culture is “ill,” assessment is a crucial first step. Using an established assessment tool can help ensure more thorough data collection.

Doing the most good

The Patient Protection and Affordable Care Act of 2010 provides many benefits.

Drugs Today – November 2008

Web Exclusive! An update of drug news, including alerts, approvals, and removals at www.AmericanNurseToday.com/journal.

Drugs Today – September 2008

Web Exclusive! An update of drug news, including alerts, approvals, and removals at www.AmericanNurseToday.com/journal.

During an emergency: Be safe!

Thousands of accidental chemical spills and leaks take place in this country each year. Providing nurses with adequate first-receiver training can help ensure that we can care for…
Acute,Compartment,Syndrome,Word,,Medical,Term,Word,With,Medical,Concepts

Early detection of acute compartment syndrome

Acute compartment syndrome (ACS) is a surgical emergency that requires early identification to avoid permanent disability of the affected extremity. ACS is a clinical diagnosis. When assessing for…

Easing the way for the electronic health record

Pressure is building to develop a national electronic health record – and the nursing profession is playing a pivotal role in developing the standards needed to support it.

Ectopic pregnancy

Courtney Thomas*, a 30-year-old patient, is 6 weeks pregnant with occasional mild lower abdominal pain and vaginal spotting. While in the outpatient lab, she experiences a diaphoretic episode…

Ending the cycle

Nurses nationwide work to eliminate partner violence.
Curriculum_Technology

Enhancing nursing curriculum with an injection of technology

Use online tools to engage and motivate students. Evidence-based research has changed teaching from a traditional teacher-centered approach to a student-centered (constructivist) approach. According to neuroscience research, the…

Ensuring quality and saving time

The National Database of Nursing Quality Indicators&#174 tracks the care nurses provide, helping to improve nursing practice, patient outcomes, and the work environment.
health safety environment musculoskeletal disorder nurse

Environment, health and safety

ANA has been very concerned with and involved in the issue of ergonomic hazards as a health and safety concern in the workplace. Musculoskeletal injuries resulting from patient…

Environment, health, & safety

With the growing reuse of single-use medical devices, ANA supports improvements in end-of-use product management and research on ethical and safety issues related to these devices.

Environment, health, & safety

Is widespread triclosan use leading to microbial resistance? ANA urges nurses to take a cautionary approach toward using triclosan-containing products at home.

Environment, health, & safey

Help reduce the toll of seasonal influenza by receiving, administering, teaching about, or encouraging seasonal influenza vaccination. This article is available to American Nurses Association members and ANJ…
esophageal

Esophageal varices

Darrel has been drinking 1 pint of whiskey each day for 35 years. He worked in construction until he was terminated for absenteeism. His family reports that he’s…

Evidence-based interventions for dyspnea

Editor’s note: One of a series of articles on managing cancer-related symptoms from the Oncology Nursing Society. Dyspnea is “a subjective experience of breathing discomfort that consists of…

Eye of the beholder: Grand rounds at the museum

“What do you see in his eyes?” asks Dr. Rothenberg. After a brief pause, someone replies, “He looks sad.” Another states, “He’s kind of emaciated.” After directing us…
faculty shortfall nurse

Faculty shortfall

Helen O’Shea, PhD, RN, hasn’t retired completely from her role as a nurse educator, and that is very fortunate, for the number of nurse faculty is dwindling, with…

Family initiated rapid response team

Rapid response isn’t just for staff. More hospitals are allowing, even encouraging, patients and their families to make the call for help.
FES

Fat embolism syndrome

Early identification prevents negative outcomes.    Takeaways: Fat embolism syndrome is a rare complication that can occur after traumatic orthopedic injuries. Early identification of neurologic, respiratory, and dermatologic symptoms…
Fine-tuning your feeding-tube insertion skills - American Nurse

Fine-tuning your feeding-tube insertion skills

Even if you’re accustomed to inserting feeding tubes, the procedure can cause complications. The authors provide safety guidelines to help you make feeding-tube insertion safer.
The art of self-disclosure

From our readers: The art of self-disclosure

One aspect of the “art” of nursing is appropriate self-disclosure. Nurses and other healthcare providers often have an opportunity to share information about their own health to help…

From our readers….Caring for Haiti from afar

The devastation in Haiti following the earthquake caused many of us in healthcare to come to a standstill. I am heartsick watching the suffering that the people of…
Fruits and Vegetables are dietary Staples of Caring for patients with metabolic syndrome

From our readers…Hunger advocacy for nurses

Since the mid-1990s, the number of hungry people worldwide has been steadily increasing. Currently about 925 million people worldwide are hungry—about 1 in 7 of the global population.…
nonadherent refuse treatment nurse challenged challenge

From our readers…Nonadherent or compassion challenged?

Over the years nurses have labeled patients who choose (knowingly or unknowingly) to disregard instructions that could potentially alter their health condition toward a “better outcome” as noncompliant,…
nurse grief overcome

From our readers…The nature of grief

A wise person once said, “Grief is not a disease or pathology to be cured. Grief is the tangible evidence that we’ve cared and loved someone.” The author…
slow steady wins safety rush procedure

From our readers…Three elephants for safety

A familiar safety protocol in hospitals is the time-out. Mandated for many invasive procedures, this “work stop” ensures the right site, right procedure, and right patient are verified…
value skills nurse career job transition

From our readers…Value all your skills

Anyone who’s been a nurse for more than 10 years will agree with me: you can make big leaps from specialty to specialty and sometimes leave a skill…

From the other side of the bed

How long has it been since you looked at the ambience of a hospital with a critical eye? If you practice there, have you thought about how the…

From your ANA President

Nurses are natural innovators. Let’s recognize our strengths as innovators and share our ideas on multiple platforms.
safe staffing healthcare

From Your ANA President

HAVING WORKED in an emergency department for more than 20 years, I know what it’s like to have to think fast and move fast to save a life.…
cpr cardiopulmonary resuscitation

From your ANA President

As healthcare professionals, we all know CPR to mean “cardiopulmonary resuscitation,” and we have all been trained in how to perform it. But CPR also has another important…
fund funding research nursing

Funding the future of nursing

What do ANA members Pamela Mitchell, Elaine Larson, Ann Rogers, and Dorothy Brooten have in common? Early in their careers, each received a research grant from the American…

Get Savvy to syncope

Syncope is a common occurrence and is commonly benign. But sometimes a swoon signals a serious underlying condition. Learn what causes syncope and how to assess and intervene…

Getting a grip on GERD

Most patients manage the heartburn, nausea, and belching of gastroesophegeal reflux disease with lifestyle changes and medications. But some may experience a dangerous symptom cluster that warns of more…
carbohydrate counting

Getting comfortable with carbohydrate counting

Mr. Tucker,* a 20-year-old man with type 1 diabetes, is admitted to the hospital for a severe hypoglycemic event. For about a month, he’s experienced these events about…

Getting to the root of the root-cause analysis problem

With national attention focused on the unacceptable prevalence of medical errors, the healthcare sector has turned to highly reliable industries, including aviation and nuclear power, to learn about…

Giving from the heart

The December calendar lights up with many religious and cultural celebrations such as Hanukkah, Islamic New Year, Christmas, and Kwanza, times for gathering with family and friends to…

Global climate change and nursing’s role

Nurses must educate themselves and the community about the effects of global climate change. This article is available to American Nurses Association members and ANJ subscribers only. Already…

Going from the gut

The current emphasis on best practices, guidelines, and checklists make cause healthcare professionals to turn off their judgment and go by the book – even when it’s the…

Going with the flow of infusion nursing

Thanks partly to the new Medicare and Medicaid hospital reimbursement rules and the trend toward home health care, infusion nurses are in greater demand than ever. As hospitals…

Good intentions eclipsed

Leah Curtin discusses how negative effects of work on work/life balance and mandatory overtime affect patient care.

Grasping the all-important concept of risk

To fulfill your responsibility toward evidence-based practice, you need to understand statistical techniques. In the first article in our new “Spotlight on Statistics” series, the authors demystify the…

HAART and its effects on the heart

Many patients with HIV/AIDS are doing well on highly active antiretroviral therapy (HAART). Yet HAART can increase cardiovascular risks by reducing high-density lipoprotein levels, raising triglyceride levels, and…

Halting postpartum hemorrhage

When excessive blood loss during delivery threatens a mother’s life, quick assessment, effective interventions, and expert aid from the rapid response team maneuver her postpartum course back onto…

Handling with care: The bariatric patient

Technological advances, special equipment, and screening algorithms help healthcare facilities and nurses meet the needs of bariatric patients while reducing worker injury.

Headlines from the Hill

Find out what has been accomplished during the 112th Congress and what healthcare professionals stand to lose if our country goes over the "fiscal cliff."

Headlines from the Hill

ANA CEO “stars” with actress Jessica Alba in the fight against toxic chemicals.

Healing our hazardous environment

Environmental pollution threatens our homes, workplaces, and communities. So what can you do? This article will tell you.

Healing the wounds: Quantum nursing V

Quantum nursing demands that nurses honor each person’s humanity, promote independence and autonomy, and offer the opportunity for individuals to redefine for themselves who they are and how…

Healthcare needs a swoosh

Does healthcare need its own type of “swoosh” as a daily inspiration for us to do the right thing without hesitation? Our Editor-in-Chief answers that question and explores…

Helping Dave lose weight

Key takeways The Modified 5As framework, combined with the Transtheoretical Model (TTM), guides nurses to provide patient-centered, collaborative weight-loss counseling that promotes self-efficacy. Nurses can feel confident in…

Helping patients survive sepsis

In its early stages, sepsis can be difficult to detect. Learn about the sometimes-subtle signs and symptoms.

Hemothorax

Treatment for respiratory distress follows the ABC acronym (airway, breathing, circulation). Responders must first ensure adequate ventilation and oxygenation and then perform FAST, a point-of-care investigative tool for…

Hepatitis A: Outbreak update

Be sure your knowledge is up-to-date. HEALTHCARE WORKERS are well aware of their risk for hepatitis B from exposure through occupational needlesticks and bodily fluid. And they know about…

Hepatorenal syndrome and large-volume paracentesis

Averting a Crisis. Takeaways  Hepatorenal syndrome (HRS), impaired renal function resulting from advanced liver disease, is characterized by renal vasoconstriction, systemic vasodilatation in the absence of other identifiable…

Herbal facts, herbal fallacies

Many people assume herbs can’t cause harm, and neglect to tell healthcare providers they’re using them. This article will boost your herbal awareness and help you eradicate herbal…

Herbal facts, herbal fallacies

Your sister-in-law gets frequent migraines and wants to try a “natural” therapy to help prevent them. A preoperative patient tells you she’s taking a “memory-boosting” herb. A friend…

Herbal facts, herbal fallacies

Many people assume herbs can’t cause harm, and neglect to tell healthcare providers they’re using them. This article will boost your herbal awareness and help you eradicate herbal…

High-level disinfection and sterilization

Nurses should have reprocessing knowledge, training, and competency. Takeaways  In 2018, more than 50% of hospitals surveyed by The Joint Commission were found to be noncompliant with high-level…

Hospital-acquired infections mortalities, costs

Two common conditions caused by hospital-acquired infections killed 48,000 people and ramped up health care costs by $8.1 billion in 2006 alone, according to a study released Feb.…
informatics nursing nurse info tech science computer nursing

How about a career in nursing informatics?

Do you have an aptitude for information technology (IT)? Would you like to help transform health care and bridge the gap between IT and nursing practice? If so,…

How dolls can help patients with dementia

One evening while making rounds in the geriatric psychiatry unit, a nurse manager heard a patient crying in a little girl’s voice and pleading for her mother and…

How to achieve success in quality improvement

To achieve sustained improvement in patient outcomes, create a work environment that promotes a commitment to excellence and examine NDNQI data on your organization’s current performance level.

How to deliver bad news

Healthcare providers often must give bad news to patients and families. Doing this in a direct, concise, compassionate way is a skill that equired practice.

How to fight fatigue in patients with cancer

“Cancer’s paint box includes many shades of fatigue.” —Dana Jennings, a patient with prostate cancer who blogs for The New York Times The shock of a cancer diagnosis.…
How to recognize and respond to hypovolemic shock

How to recognize and respond to hypovolemic shock

Fluid loss…poor tissue perfusion…oxygen deprivation…acidosis…multisystem organ failure. Unless interrupted, the scary chain of events in hypovolemic shock leads to death. Learn how to hault this perilous process with…

Hypersensitivity infusion reaction management

Before implementing a nurse-driven protocol at our multicampus hospital, nurses practicing in oncology settings gained general knowledge of emergency management of hypersensitivity infusion reactions through didactic instruction, but…

Hyperthyroidism: A storm brewing

Sarah Woods*, a 46-year-old woman with type 2 diabetes mellitus, arrives at the endocrinologist’s office for a routine visit. She complains of fatigue, anxiety, and “a racing heart.”…

Hyponatremia signals acute adrenal insufficiency

Maryann Ward, age 56, is admitted to the chest pain unit. Sara, her nurse, finds her alert and oriented. Mrs. Ward tells Sara her chest pain started yesterday. When assessing her, Sara…

I have diabetes. How do I live with it?

As a nurse for 36 years, I’ve always enjoyed caring for patients with diabetes. But for many of them, this disease isn’t their only health problem. Many also…

Implementing evidence-based practice in long-term care

Long-term care (LTC) facilities are faced with many care hurdles, including a growing geriatric population, complexities associated with chronic conditions, and an insufficient workforce. Evidence-based practices (EBPs) facilitated…

Improving how we use and respond to clinical alarms

Nuisance alarms, false alarms, and hard-to-identify alarms can imperil patient safety. The author describes ways to manage clinical alarms more efficiently. This article is available to American Nurses…
Improving sleep

Improving sleep in patients with heart failure

The DREAM bundle is a simple, effective tool. Takeaways: Sleep disturbances are among the most commonly reported symptoms of heart failure. Educating patients with heart failure about sleep…

Improving the care of stroke patients

Is your facility doing enough to help stroke patients survive and regain functional independence? Find out how a national evidence-based initiative helps hospitals deliver better stroke care.

Introducing the quantum patient

The quantum patient is an indivisible human being whose health problems might not be healed through traditional specialization.
Is it Addison’s disease or Cushing syndrome?

Is it Addison’s disease or Cushing syndrome?

Both of these complex endocrine disorders involve the adrenal glands and cause abnormal cortisol levels. Based on physical and laboratory findings, could you determine which one your patient…

Issues up close

How NDNQI® data are helping top hospitals improve nursing quality

Issues up close

ANA has joined the Partnership for Patients to improve patient safety.

Issues up close

ANA is taking steps to ensure that nurses are recognized for their care-coordination activities. This article is available to American Nurses Association members and ANJ subscribers only. Already…

Issues up close

ANA’s House of Delegates recently approved a resolution supporting health care for all. The author examines the social, economic, and political ramifications of undocumented immigrants’ lack of access…

Issues up close

To increase health literacy, we need to educate patients and consumers about health issues in a more meaningful, individualized, and patient-oriented way.

Issues up close

With the persistent focus on maintaining high childhood immunization rates, it’s easy to lose sight of the importance of adult immunization. But nurses must not allow such lapses…

Issues up close

Family nurse practitioner (FNP) and nurse-midwife Karen Holder, FNP-BC, CNM, MHS, sees patients at a large primary care clinic in Flagstaff, Arizona, as well as at small satellite…
flu-vaccine

Issues up close

ANA’s “Bringing Immunity to Every Community” campaign aims to boost RNs’ knowledge of immunization, encourage them to get vaccinated, and position them as leading immunization advocates.

Issues up close – Fighting the invisible

MRSA, Clostridium difficile, and newly emerging “superbugs” are penetrating deeper into both healthcare and community settings. We need to use critical-thinking skills and rigorous infection control practices to…

Keep kids moving

One-third of American children are overweight or obese. Although many factors contribute to this epidemic, one cause for the rise in childhood obesity is a decrease in physical…

Keeping asthma at bay

NIH has updated its guidelines on asthma diagnosis and treatment. Learn how to help your asthma patients lead fuller lives.

Keeping asthma at bay

NIH has updated its guidelines on asthma diagnosis and treatment. Learn how to help your asthma patients lead fuller lives.

Keys, please

Discusses the problem of when it’s unsafe for an older person to drive.

Letter to the Editor

Consider adoption You are skilled at the art of patience. You know you to give excellent care under pressure. You know how to show care and then say…

Letters to the Editor – April 2007

Provocative cover art? Although I’m impressed with the overall quality of your publication, the cover of your February issue (“Heart disease: A woman’s worst enemy”) surprised me. Was…

Letters to the Editor – August 2008

Nursing pins, nursing pride   I read the letter “Nursing school pin: Not for sale at any price” in your June issue with great interest. Like Theresa Stephany, I…
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Letters to the Editor – December 2008

A glimmer of hope after breast cancer I want to thank Mary K. Hughes for her article “Sex after breast cancer: Helping your patient cope” (October). I was…

Letters to the Editor – February 2008

Lack of evidence-based care for spinal cord injuries In your September article “Cervical spine injuries: Preserving function, improving outcomes,” the author describes as “aggressive care” the administration of…

Letters to the Editor – January 2009

Why not a bachelor’s degree in 10? I agree that advanced education for RNs should be mandated, as described in “BSN in Ten” in the November issue. I…

Letters to the Editor – July 2007

Oversight not needed As a recent graduate of a nurse practitioner (NP) program, I appreciated your article “Retail-based clinics: New option for nurses” in the March issue. You…

Letters to the Editor – July 2008

Sacred cows and road runners American Nurse Today is one of the few publications I look forward to receiving, and I read it from cover to cover. It…

Letters to the Editor – June 2007

Float or be fired? The February article “Protecting yourself from malpractice claims” states, “Don’t accept assignments if you’re not sure you’re competent to perform them.” How does a…

Letters to the Editor – March 2009

Avoiding the dangers of I.V. phenytoin  As an infusion nurse specialist, I’d like to add some information to and clarify some points in “Phenytoin: Keep patients in the…

Letters to the Editor – May 2007

Show us the money I agree wholeheartedly with the idea of employing nurses in or near retirement to increase the size of the professional workforce, as suggested in…

Letters to the Editor – May 2008

Dimensions of pain distraction I read with applause “Assessing the seven dimensions of pain” in the February issue. I work in a large teaching institution in the Midwest,…

Letters to the Editor – May 2009

Speaking of psychic experiences Beth Wechsler’s article “A word about patients’ psychic experiences: Listen” in the March issue deserves to be widely read and discussed. The extrasensory experiences…
letter letters mail editor

Letters to the Editor – November 2007

A timely expression of support “Being with dying” in the September issue was timely for my staff and me. I am an RN Unit manager for a 46-bed…

Letters to the Editor – November 2008

Easy and inexpensive   Thank you for Susan Fetzer’s excellent article, “Putting a stop to postop nausea and vomiting,” in the August  issue. One treatment that wasn’t mentioned is…

Letters to the Editor – October 2008

Novice nurses: Leading the way against nurse abuse  In the informative and timely article “No more nurse abuse” (July), John Murray points out that novice nurses are more…

Living a healthy lifestyle

As nurses, we know how to check blood pressure, administer medications, and counsel patients about healthy living. But let’s face it—some of us don’t practice what we preach.…

Lyme carditis: A clinical case report

A 19-year-old college student arrives at the campus student health clinic after feeling faint while out for his routine run. He tells the health clinic RN that during…

Make a difference as a rehabilitation nurse

From September 21 to 27, we celebrate National Rehabilitation Awareness Week by promoting the value of rehabilitation, highlighting the opportunities for the nearly 50 million Americans with disabilities,…

Making a stand against malignant melanoma

Summer sizzles on, sun-worshipers soak up the rays. Years later, your ability to detect melanoma in its early stages could spell the difference between a patient’s prompt treatment…

Making resolutions, making meaningful changes

Did you make a New Year’s resolution? If so, how’s your resolve holding up? According to researchers, after 1 month, 75% of resolutions are being kept. The number…

Making sense of statistical power

Want to improve your ability to interpret research studies? Take a few minutes to read this overview of power analysis, probability, sample size, and related concepts.
malignant-hyperthermia

Malignant hyperthermia

Malignant hyperthermia is a genetic life-threatening disease that results in an uncontrolled release of calcium that causes the body to go into a hypermetabolic state. It’s triggered by…

Managing acute decompensated heart failure

Patients with stable chronic heart failure may suddenly start decompensating. Do you know how to recognize this condition and help avert organ failure?
delirium in Pediatric Patients

Managing delirium in the pediatric patient

Today you’re caring for 8-year-old Ethan*, who ran between two parked cars while chasing his basketball and was struck by a passing vehicle 2 days ago. His left…

Managing dysphagia in elderly patients

The risk of developing dysphagia (difficulty swallowing) increases with age and exposure to aging-related diseases and conditions. Roughly 7% to 10% of adults older than age 50 have…
Managing end-of-life symptoms

Managing end-of-life symptoms

For patients nearing death, palliative care can enhance quality of life by easing pain and other symptoms, improving sleep, and reducing fatigue. Managing end-of-life symptoms

Managing knee osteoarthritis in older adults

A degenerative joint disease, osteoarthritis (OA) is marked by cartilage erosion, osteophyte formation, joint hypertrophy, and subchondral sclerosis. A leading cause of disability in older adults, it affects…
migraine, nursing journal, healthcare, nursing

Managing migraine in underserved populations

Collaboration addresses barriers to care. Takeaways: Managing migraine in underserved populations presents unique challenges in an urban outpatient neurology clinic. Barriers to care include psychiatric comorbidities, sleep disorders,…
Medication errors Best Practices

Medication errors: Best Practices

A medication error can occur in any healthcare setting-with devastating consequences. The authors describe weaknesses in the key elements of medication use and propose ways to make drug…
spiritual care

Meeting your patients spiritual needs

When a patient says, “I’m afraid I’m going to die,” do you offer empty reassurances? Find an excuse to leave the room? Read this article to learn about…

Memory pegging

Forgetting is frustrating. To make memorizing fun, “peg” each item on your to-do list.

Microalbumin: Little test, big payoff

The earlier renal disease is detected, the better. That’s why the microalbumin test is so important for patients with certain chronic conditions.

Mitigating the threat of lost knowledge

A looming shortage of expert nurses requires strategies to accelerate knowledge transfer. Takeaways: Healthcare organizations are facing the challenge of retaining expert knowledge as the nursing workforce transitions…
mobile diet exercise apps adolescent weight loss

Mobile diet and exercise apps for adolescent weight loss

Innovative approaches can encourage healthy eating and activity in adolescents. Takeaways: Nurses can help their adolescent patients with obesity by encouraging a healthy diet and greater activity Smartphone…

Mobile stroke units

Mobile stroke units (MSUs), ambulances equipped to evaluate, diagnose, and treat strokes in the prehospital environment, decrease door-to-thrombolytic administration time, cut door-to-thrombectomy time, reduce the risk of mortality…

Moving toward a restraint-free environment

Sherry, age 17, is admitted to a behavioral health residential facility by her adoptive parents. She has mild mental retardation and attention deficit hyperactivity disorder. Recently, she reported…

Mumps on the rebound

After decades of dormancy, mumps is back and could be making an appearacne soon at a clinic or hospital near you.
emergency department nurse

My First Day in the ED

Note: This article was written before Kenneth graduated from nursing school. My first experience in an emergency department (ED) setting happened last week at Frankfort Regional Medical Center…
myocardial-infarction

Myocardial infarction: Nursing assessment and care

Rapid nurse identification of myocardial infarction in medical surgical patients is key to achieving lifesaving treatment in the heart catheterization lab. Focused chest pain assessment, 12-lead ECG performance,…
myocarditis

Myocarditis and COVID-19

In a COVID-19 pandemic and vaccination world, nurses should raise their clinical suspicion for myocarditis when healthy, young, or athletic patients present with fatigue, palpitations, and chest pain.…
myxedema-coma

Myxedema coma

Myxedema coma is the most severe, potentially life-threatening form of hypothyroidism and a medical emergency. It frequently results from untreated or undertreated hypothyroidism. Hallmarks of myxedema coma include…

Nanotechnology and the environment

Nanotechnology and the environment By Katie Slavin, MS, RN Nanotechnology is the use of innovative techniques for controlling and manipulating matter at the near-atomic scale to produce engineered…
Neurocysticercosis

Neurocysticercosis: More than a headache

Neurocysticercosis, the most common parasitical infection of the central nervous system, is caused by accidental ingestion of eggs from Taenia solium (pork tapeworm). This potentially fatal infection is…

New report reaffirms old concerns

In a new report, The National Toxicology Program (NTP) expressed ”serious concern” that diethylhexyl-phthalate (DEHP), a chemical used in medical devices, may affect male reproductive tract development and…

No drugs down the drain

You can use the questions and answers below when teaching patients about proper medication disposal. Question: Why should I clean out my medicine cabinet? Answer: It’s good to…

No peeking allowed

Electronic health records give healthcare providers faster, more efficient access to patient information. Experts hope to make the data less vulnerable to security breaches.

Noninvasive ventilation makes a comeback

Although it’s not suitable for all patients, noninvasive positive pressure ventilation reduces many of the risks associated with mechanical ventilation.
nurse contribution patton zalon

Nurising’s contribution to patient care

Editor’s note: This month’s column is cowritten by Rebecca Patton and Margarete L. Zalon, President of the American Nurses Foundation. We have stories to tell about nurses and…

Nurse-sensitive indicators: Integral to the Magnet journey

To help earn Magnet designation, Children’s National Medical Center established TPN and lipid error elimination as a unit-based nurse-sensitive indicator. Its implementation improved patient-care outcomes, enhanced nurses’ pride,…

Nurses and preventive foot care

Out of fear of contracting COVID-19 and overall travel challenges, many individuals missed healthcare provider appointments and neglected some routine care. This led to complications that might otherwise…

Nurses caring and sharing

From the U.S. to Uganda, in sleek American hospitals and makeshift Afghan clinics, nurses give of themselves to transform lives. Compelled by a deep passion to aid people…
future nursing present

Nursing – today and beyond

Nursing is in the midst of revolutionary changes. How are these changes affecting the profession today—and how are they likely to affect it in the future? For the…

Nursing Green teams: Volunteer today

By Holly Carpenter, BSN, RN At work, have you felt short of breath or nauseous from inhaling fumes from cleaners/sterilants/disinfectants? Do you and your patients want access to…

Nursing quality: Strength in numbers

"In God we trust. All others must bring data." The National Database of Nursing Quality Indicators® (NDNQI®) collects data that can improve the quality of care.
Nutrition for night-shift nurses

Nutrition for night-shift nurses

Pam has worked the night shift for more than 30 years. Over the last 3 years, she has lost 100 lb—and kept it off. She describes the challenging…

Of artichokes and angry patients

An angry patient is like an artichoke. An artichoke is prickly and rough on the outside, but by taking time to learn how to peel its rough leaves,…

Ogilvie’s syndrome: No ordinary constipation

A patient complains of bloating, abdominal tenderness, and constipation. Nothing unusual? Maybe. But if you’re too quick to dismiss these symptoms, you could be overlooking a serious condition called…
prefilled-flush-syringes

One and done: Prefilled flush syringes

Reinforce safe practices in your organization. Editor’s Note: This is an early release of a web exclusive article for the July 2021 issue of American Nurse Journal. The…
Opening the lines of communication about HPV

Opening the lines of communication about HPV

When parents resits the HPV (human papillomavirus) vaccine, be prepared to listen and educate. Takeaways Patients and parents may have misconceptions about the purpose of the HPV vaccine.…
Emergency,Cpr,On,A,Man,Who,Has,Heart,Attack,,

Opioid overdose cardiopulmonary emergencies

Over the past 10 years, opioid-related overdoses and death have steadily increased across the United States. The World Health Organization indicates that about half a million deaths are…

Osteoporosis-not just for women

Most elderly men don’t know they are at risk for osteoporosis-and they probably won’t find out until a nurse tells them.

Ostomy basics

Several myths about ostomies exist, including that they’re malodorous or messy, they interfere with daily activities and hobbies, and they limit quality of life. However, for most patients,…

Our “knowing-doing” gap

Something as simple and low – tech as the checklist can help healthcare providers close the knowing – doing gap.

Our Readers Respond

Problems with privacy The policies developed around privacy, at least in LTC [long-term care], are rigid, and often inappropriate given the age and often confusion (especially with infections)…

Our Readers Respond

Overcoming the fear of floating “Tips for floaters” (March 2010) accurately described the floater’s dilemma. By showing both sides of the coin—the floater’s and the staff nurses’ on…

Our Readers Respond

No drugs down the drain In approximately 2008 I wrote my final paper in BSN community health on this environmental issue. I am delighted to see that this…

Our Readers Respond

Break the bullying cycle I read with great interest the article “Break the bullying cycle” in the January 2012 edition of American Nurse Today. Terri Townsend provides an…

Our Readers Respond

Of artichokes and angry patients I agree with the premise of Rossiter and Lazoritz’s article, “Of Artichokes and Angry Patients” that nurses are often the recipients of displaced…
submission submit high energy drink substance abuse

Our readers respond

Concurring on “quantum” nursing I was delighted with Leah Curtin’s eloquent description of the beliefs I’ve embraced in my nursing career (“Quan­tum nursing,” September 2010). I have “preached”…

Our Readers Respond

Nursing academics vs. practicing nurses? My blood boiled when I read ANA President Patton’s column “Is diagnosis of pressure ulcers within an RN’s scope of practice?”(January 2010). It…

Our Readers Respond

Family initiated rapid response team After reading the article “Family initiated rapid response team (FIRR)” by Ehrig S., Hepburn, J., Riley, P., and Smolen, A., in the American…
submission submit high energy drink substance abuse

Our Readers Respond

The truth about high-energy drinks Re “High-energy drinks: What you don’t know could hurt you” (August article available here): I am very impressed with the information…presented. I always…

Our Readers Respond

Mindfulness practice Thank you, Dr. Cipriano, for your editorial on mindfulness practice to assist in the grief process (“Breath at the belly,” July 2010). A long-time Buddhist, I…

PA catheter controversy

Standard of care in the ICU – or object of overuse, abuse, and misuse? The authors explain why they believe PA catheter use may harm more critically ill…

Paget’s disease: A therapy update

Pain, arthritis, fractures, and skeletal deformities are calling cards of Paget’s disease. A new one-dose drug therapy can produce extended remission.

Patient Nutrition

Do you routinely talk to patient’s about nutrition and their health? Please click here to participate in a very short survey about nurses and patient nutrition.
pediatric hypoglycemia

Pediatric hypoglycemia

While watching a children’s softball game on a sunny 88° F day, you see one of the players, Mia Smith*, suddenly collapse. Mia’s mother runs to her child’s…

Pediatric lead exposure

Lead has long been known to be a toxic agent. Recently, concern has been rising regarding lead exposure in children’s toys. Although lead in paint on toys has…

Pediatric stroke

Learn more about this rare but dangerous condition.

Penn again WHO/PAHO collaborating center

The University of Pennsylvania School of Nursing has again been designated as a World Health Organization/Pan American Health Organization (WHO/PAHO) Collaborating Center for Nursing and Midwifery Leadership. As…
Basics of acid-base balance

Perfecting your acid-base balancing act

When it comes to acids and bases, the difference between life and death is balance. The body’s acid-base balance depends on some delicately balanced chemical reactions. The hydrogen…

Peril on Periphery

Peripheral arterial disease is all too common – and all too often goes unrecognized.

Perioperative nurses: Keeping surgical patients safe

Perioperative nurses work on the front line caring for patients undergoing operative and other invasive procedures. They collaborate with patients, families, and members of the surgical team in…

Pertussis resurgence continues unabated

American Nurse Today…Online reported on the nationwide pertussis, or whooping cough, outbreak in June. Unfortunately, four months later, the updated news is not good. In California, where the…
Needlesticks

Pharmaceutical waste: What nurses need to know

Too often, pharmaceutical waste – much of it hazardous – shows up in our surface, ground, and drinking water. To solve this problem, the healthcare industry must work…

Pleural effusion

Early identification results in prompt diagnosis. Takeaways: Parapneumonic effusions can increase in size despite antimicrobial therapy. Nurses should be attuned to changes in pulmonary assessment parameters and prepared…
postural orthostatic tachycardia syndrome

Postural orthostatic tachycardia syndrome

Get your patients back on their feet with thorough assessments that lead to early and accurate diagnoses. POSTURAL orthostatic tachycardia syndrome (POTS) affects over 1,000,000 Americans (80% are…

Preparing for disaster

The power shuts down…the phones go dead…an explosion at a nearby nuclear power plant sends a dozen critically injured victims to your hospital. What actions should you take?…

Preventing airway obstruction

Complications of an anterior cervical fusion did not lead to an airway obstruction because of one nurse’s assessment skills and critical thinking.
STEADI, nursing, nursing journal, healthcare, american nurse journal

Preventing falls in long-term care facilities

On November 8, 2019, Ms. Jane Broom’s* heirs filed a lawsuit against Holy Acres Nursing Home claiming negligence. Ms. Broom was admitted to the nursing home after a…
Preventing polypharmacy in older adults

Preventing polypharmacy in older adults

Polypharmacy refers to the effects of taking multiple medications concurrently to manage coexisting health problems, such as diabetes and hypertension. Too often, polypharmacy becomes problematic, such as when…

Primary hypothyroidism: More common than you think

Be alert to this frequently unrecognized condition. Takeaways: Hypothyroidism develops slowly over time and if left undiagnosed may put patients at risk for serious conditions, including cardiovascular disease,…
Osteoarthritis

Proactive intervention for osteoarthritis

Osteoarthritis (OA) affects 27 million Americans and is one the most common causes of disability. It negatively affects the quality of life for many, but often patients don’t…

Problems with Privacy

Leah Curtin discusses how the Health Insurance Portability and Accountability Act (HIPAA) has been misinterpreted to the detriment of patients.

Promoting nonhazardous alcohol use by older adults

Roughly half of adults ages 65 and older drink alcohol. Although experts continue to debate the possible health benefits of alcohol when consumed in minimal daily amounts, alcohol’s…
human papillomavirus (HPV) vaccine

Protect yourself and your patients with vaccination

Why is immunization so crucial for nurses? Which vaccinations should all nurses get? Find out with this educational handout focusing on national efforts to reduce vaccine-preventable disease through…
Protecting yourself from malpractice claims

Protecting yourself from malpractice claims

As nursing practice becomes more autonomous, nurses are becoming more vulnerable to lawsuits. Learn how to avoid being sued for malpractice and what to do if you are…

Psychiatric nurses are in demand

Built on therapeutic communication and relationship development, psychiatric nursing is the basis of all nursing. A core healthcare profession, psychiatric nursing provides primary mental-health care in the private…

Putting a stop to postop nausea and vomiting

GI distress after surgery is a scary prospect for patients, and an all-too-common reality. But it isn’t inevitable. Learn how to minimize your patients’ risk and relieve their…

Putting an end to patient overcrowding

Serious patient-flow problems call for more than just quick fixes. In some facilities, the culture must be transformed before patient bottlenecks can be banished. Read about one hospital’s…

Putting the breaks on pulmonary edema

I.V. fluids should help a dehydrated patient, but for one with a history of atrial fibrillation and coronary artery disease, they could contribute to pulmonary edema. For Grace…
Pyelonephritis

Pyelonephritis

Early identification results in a positive outcome.     Candance Walker* is a 28-year-old woman who arrives in a wheelchair in the emergency department accompanied by her husband. She’s crying…
awhonn womens health obstetric neonatal nurse

Q&A with the Executive Director of AWHONN

In May, we celebrate Nurses’ Week, Women’s Health Week, and Mother’s Day. In the spirit of these celebrations, we asked Joseph C. Isaacs, CAE, Executive Director of the…

Quantum nursing

When you bring your life energy, focus, and intention to patients, you’re practicing quantum nursing.

Quiz Time

A nurse working in the intensive care unit administers 100 mg of diazepam I.V. as ordered by the new resident. Although she checks on the patient often and…

Quiz time

Which sedation strategy for ICU patients on mechanical ventilation can help mitigate post-intensive care syndrome? a. Keep the patient heavily sedated. b. Use the lightest level of sedation…

Quiz Time

Which of the following is an advantage of a dry-suction chest drainage system? a. Lower levels of suction pressure b. Variable bubbling, which indicates proper functioning c. A…

Quiz time

Which of the following does not help address issues related to post-intensive care syndrome? a. Diaries kept jointly by family, ICU staff, and physicians b. Post-ICU clinics for…

Quiz time

Which of the following does not help address issues related to post-intensive care syndrome? a. Diaries kept jointly by family, ICU staff, and physicians b. Post-ICU clinics for…
school nurse

Quiz Time

Which of the following are not sources of standards of care? a. Institutional policies and procedures. b. State nurse practice act c. Published standards for specialties d. Online…

Quiz Time

Which statement about breast-feeding and obesity is correct? a. Breast-feeding has no effect on the risk of obesity in children. b. Breast-feeding is associated with a higher risk…

Quiz Time

The best noninvasive way to gauge tissue perfusion in patients with sepsis is to measure: a. systolic blood pressure. b. diastolic blood pressure. c. mean arterial blood pressure.…

Quiz Time

A goal of the induction phase of therapeutic hypothermia after cardiac arrest is to: a. quickly warm the patient to target body temperature. b. slowly cool the patient…

Radiation therapy 101

More than half of cancer patients get radiation therapy. This article gives a basic overview of this potentially life-saving treatment, discusses nursing interventions for radiation patients, and tells…
Radiation therapy 101

Radiation therapy 101

More than half of cancer patients get radiation therapy. This article gives a basic overview of this potentially life-saving treatment, discusses nursing interventions for radiation patients, and tells…
pulmonary edema

Re-expansion pulmonary edema

An uncommon complication with serious consequences  Takeaways: Re-expansion pulmonary edema is a rare complication of pleural drainage with potentially fatal consequences. Nurses should suspect re-expansion pulmonary edema and…

Readers Respond

Correction The January 2013 article “Helping patients survive sepsis” mistakenly listed “respiratory rate slower than 20 breaths/minute” as one of the diagnostic criteria for systemic inflammatory response syndrome…
hyponatremia

Recognizing acute hyponatremia

Sam Johansen, age 42, is admitted to the medical-surgical unit after 3 days of acute nausea, vomiting, and watery diarrhea associated with acute abdominal pain. His nurse, Megan,…
Rapid Response

Recognizing autonomic dysreflexia

Your quick action ensures a good outcome.     Takeaways: Autonomic dysreflexia results from a noxious stimulus, such as a distended bladder or bowel. Signs and symptoms include sweating, hypertension,…

Recognizing depression in children

All kids can be moody and unpredictable. But for roughly 5% of children, behavioral changes reflect depression. Learn why depression holds added dangers for children – and how you…

Recovery lessons from the Sandy Hook trauma

Children are people with small hearts and big emotions that often come from the people around them, particularly family members. As a pediatric nurse and mother of two…

Reducing catheter-associated urinary tract infections

Infections related to urinary catheters are the most common type of healthcare-acquired infection. The author describes his pilot study of an evidence-based intervention to reduce these infections.
telemetry

Reducing overuse of telemetry

Editor’s note: This is a web exclusive article for the July 2021 issue of American Nurse Journal. Strategies for nurses Continuous cardiac monitoring or telemetry is commonly used…
nurse reflection

Reflections on the heart of nursing

In 1995, I toured the Florence Nightingale Museum in London. On the walls were letters that chronicled a lifetime of dedication, spent caring for others—letters that were preserved…

Respiratory failure from a myasthenic crisis

Nina Robbins, age 36, is admitted to the medical unit with pyelonephritis. She states she has had a fever above 102° F, back pain, vomiting, and painful urination…
Hypertensive

Responding to a hypertensive crisis

Clifton Jones, an African-American male aged 59, comes to the emergency department (ED) complaining of headache and blurred vision. After the triage nurse measures his blood pressure (BP)…
Dealing with difficult people

Responding to a sentinel event

Sentinel events happen even in the best hospitals. Do you know what these events are and how to handle them?

Reversing opioid-induced respiratory depression

For a patient receiving high-dose opioids, frequent monitoring of the sedation level and quick intervention when that level increases stops respiratory depression from claiming another victim.

Reversing SIADH

When a cancer patient’s thirst increases and urine output decreases, suspect syndrome of inappropriate antidiuretic hormone.

Revisiting CLABSI prevention strategies: Part 2

When a patient’s healthcare team determines that a central line is needed (see myamericannurse.com/revisiting-clabsi-prevention-strategies-part-1), proper maintenance is required to prevent CLABSI and prompt action is needed if one…

Revisiting CLABSI prevention strategies: Pt 1

Follow the basics to keep your patients safe. Takeaways: · Central line–associated bloodstream infection prevention requires meticulous attention to insertion, care, and maintenance of central lines. · Collaboration…

Safe lifting: The assessment imperative

If you lift or transfer patients, make “Assess first, lift later” your motto. Find out which critical patient and ergonomic factors you must evaluate before starting any patient-handling…
Safe sharps disposal in the home

Safe sharps disposal in the home

Nurses can easily dispose of sharps in the hospital, but it’s not so easy for patients at home. Learn how you can educate patients to keep them safe…

Safe staffing saves lives

ANA’s “Safe Staffing Saves Lives” campaign fights for safe nurse staffing legislation.

Save a life-wash your hands

Did you grow up with your mother insisting you wash your hands? She was right! As nurses, we all know that the simple act of washing our hands…

Save our soles

More than 29 million Americans have diabetes, and about 5% of them will develop a diabetic foot ulcer (DFU) that may require amputation. In addition to the costs…

Saved by…um…Facebook?

Author Leah Curtin analyzes a case where a juror’s entry on Facebook affected the outcome.

Saving a snakebite victim

While hiking, Paul Sawyer, age 31, is bitten twice on the right hand by a rattlesnake. When he arrives at the emergency department (ED), the team obtains STAT…
preventing suicide

Saving lives by preventing suicide

Family survivors of a suicide inevitably ask two questions: “Why?” and “Could it have been prevented?” For survivors, these questions never have satisfactory answers. The sorrow, guilt, despair,…

Saving lives with continuous ST-segment monitoring

Manay dangerous ischemic events are clinically silent. Continuous ST-segment monitoring gives early warning of the silent ischemia that many other diagnostic methods fail to detect.

Seasonal influenza vaccination and the nurse

Seasonal influenza vaccination and the nurse We are about to enter the seasonal influenza vaccination year. There continues to be concern, and rightly so, about the low seasonal…
securing vascular access devices

Securing vascular access devices

Using the right securement method can improve outcomes and reduce costs. Takeaways:  Failure of vascular access devices (VADs) can be attributed to inserter characteristics, patient-related factors, anatomic placement,…

Seeing Red

American Heart Month is a time to celebrate the wealth of information that if acted on, can help prevent cardiovascular disease.

Seizure emergencies

Quick action guides treatment. Takeaways: Status epilepticus is a seizure that last 5 minutes or more or repetitive seizures with no recovery between them. Status epilepticus is a…

Self-mutilation: The cutting truth

People who mutilate themselves excel at hiding their injuries. Find out how to identify self-mutilators and nurture their trust.

Sepsis beyond the hospital

Nurses are on the frontline of preventing sepsis in the community. Early recognition of sepsis symptoms is essential to initiate timely interventions, avoid rehospitalization, and prevent poor outcomes.

Sepsis signposts: Can you spot them?

Sepsis can show up in any setting. So even if you don’t work in a critical care unit, you need to know how to detect it. This article…

Setting your sights on aging eyes

Half of Americans older than 65 have some degree of age-related cataract formation, making cataracts the leading cause of vision impairment in the United States. As a nurse,…
oncology cancer nurse certified

Seven reasons why oncology nurses should get certified

For oncology nurses, specialty certification has become the gold standard. The Oncology Nursing Certification Corporation awards the following certifications: Oncology Certified Nurse (OCN), Certified Pediatric Oncology Nurse (CPON),…
Sexual assault screening

Sexual assault screening in the outpatient setting

Every 2 minutes, someone in the United States experiences a sexual assault. Sexual assault encompasses a number of acts ranging from inappropriate exposure or touching, to forced viewing…

Shaving as a metaphor for nursing

Over the course of history, people have used metaphors to explain, contrive, reflect, and refute human phenomena. Health care (and all its challenges) has stimulated prolific metaphors to…

Shhhhhh! Quiet zone

Nurses play a significant role in helping patients to get the sleep they need.
flame nurse condolence

Silence and Solace

“We think she’s gone,” he said. It was 6:20 p.m. I was walking down the hall on the med-surg unit, and turned to face a middle-aged man with…

Six more hot drugs for today and beyond

These six drug profiles, along with the six in the March issue of American Nurse Today, bring you up to date on significant advances in drug therapy.
bowel-obstruction

Small bowel obstruction

Abdominal pain, bloating and distension, vomiting, and obstipation are warning signs of small bowel obstruction. Small bowel obstructions are treatable if recognized early. Some bowel obstructions are life-threatening…

Spotting alcohol and substance abuse

Some 22.5 million Americans ages 12 and older have an alcohol or substance abuse problem, but only 2.3 million receive treatment. To identify and help the other 20…

Spotting trouble after spinal surgery

The rapid response team makes all the right moves when a patient experiences neck swelling and difficulty swallowing after an anterior cervical discectomy and fusion.

Stemming a lethal immunologic response

When a patient shows signs of systemic inflammatory response syndrome, her survival hinges on the nurse’s expert assessment skills and the clinical team’s swift interventions.

Stopping a downward spiral

For a patient with chronic heart failure, failure to take prescribed diuretics triggers a perilous chain of events

Stopping the silent progression of osteoporosis

Osteoporosis and low bone mass affect about 44 million Americans. Women account for 80% of that number. And each year, more than 1.5 million Americans suffer osteoporotic fractures.

Strabismus and mental health

In a recent JAMA Ophthalmology article, Lee and colleagues’ retrospective chart review found that children with strabismus (a disorder in which the eyes do not line up in…
myocardial infarction

Strategies for preventing another MI

According to the American Heart Association, each year an estimated 635,000 Americans have a new myocardial infarction (MI) and an estimated 300,000 of them have a recurrent attack.…
stroke alert ant

Stroke alert

Quick identification of stroke in a postpartum patient yields positive result. Anna Connor, a 30-year-old woman, is admitted to the medical-surgical unit with a diagnosis of pneu­­monia. Her…

Stroke in a child with sickle cell anemia

Adrienne Johnson, age 5, is admitted to the general pediatric unit. She has sickle cell anemia (hemoglobin SS subtype) and recently was discharged after being hospitalized for acute…
Respiratory changes

Subtle respiratory changes raise a red flag

Catherine Sheehan, age 94, is admitted to the medical-surgical unit with a new diagnosis of heart failure and acute kidney injury. Laboratory results show an elevated B-type natriuretic…
suicide

Suicide assessment and follow-up care

Suicide is a preventable and growing public health risk, and nurses are in a prime position to provide assessment and follow-up care. Many nurses lack sufficient education to…
covid-19 virus illustration

Superbugs trump wonder drugs

Our grandparents’ generation first witnessed the wonders of antimicrobial agents. These drugs saved millions of lives and rendered harmless a number of previously untreatable fatal illnesses. But their…

Suppressing a COPD flare-up

Nursing vigilance helps a patient with chronic obstructive oulmonary disease stave off respiratory failure.
COVID-19-tiered-staffing

Surge planning and a tiered staffing model

As soon as Piedmont Fayette Hospital (a 282-bed community hospital) received its first patient with COVID-19, leadership (including nursing, anesthesia, respiratory, and clinical education) began planning how to…
SWAT nursing specialty

SWAT nursing: A unique specialty

What does SWAT stand for? So Where Are They? Smart, Witty, and Talented? Smiling, Willing, Able, Technical? (more…)

Take Note

2/11/10 Three steps to lower childhood obesity Preschool children who do one or more of the following have a lower risk for obesity, according to a study of…
estrogen women woman note

Take Note – August 2007

Good news for younger women taking estrogen     Estrogen therapy may have cardioprotective effects for women who start taking it in their 50s. A study from the Women’s Health…

Take Note – August 2008

Web exclusive! A monthly round-up of clinical and practice news and alerts at www.AmericanNurseToday.com
ibuprofen medication meds pills pill

Take Note – December 2006

CDC recommends HIV screening for everyone New recommendations from the Centers for Disease Control and Prevention (CDC) call for routine human immunodeficiency virus (HIV) screening for all patients…
lymes disease tick

Take Note – January 2007

Controversy over new Lyme disease guidelines The new guidelines released by the Infectious Diseases Society of America (ISDA) have run into some criticism. In fact, the International Lyme…
kid eating healthy child girl veggies vegetable

Take Note – July 2008

Measles outbreak       Between January 1 and April 25, the Centers for Disease Control and Prevention received reports of 64 measles cases in nine states—the highest number for the…

Take Note – June 2007

A monthly round up of clinical, practice, and career news, updates, and alerts.
exercise child children kid obesity

Take Note – June 2008

Failure to rescue is most common safety mistake in hospitals       HealthGrades’ fifth annual Patient Safety in American Hospitals Study found that failure to rescue and other patient safety…
std teenage women girl

Take Note – May 2008

One in four U.S. teenage girls has an STD According to a recent federal study, one in four American teenage girls has a sexually transmitted disease (STD), even…
breast feeding breastfeeding baby

Take Note – November 2006

American Diabetes Association releases food guidelines for specific medical categories “When you’re talking about diabetes, there is no ‘one size fits all’ diet,” said Ann Albright, PhD, RD,…
flu shot kids note

Take Note – October 2006

CDC recommends annual flu shots for children ages 2 to 4 For the first time, the Centers for Disease Control and Prevention (CDC) is endorsing yearly flu shots…

Take Note – Sept/Oct 2009

Patients lose when nurse staffing is insufficient Heavy workloads and insufficient staffing affect patient care, according to about 2,000 nurses surveyed worldwide by the International Council of Nurses…
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Take Note – September 2008

Johnson & Johnson’s Campaign for Nursing’s Future     In 2002, Johnson & Johnson launched the Campaign for Nursing’s Future to enhance the image of nursing, help recruit new nurses…

Taking action against acute COPD

Each year, emergency departments see about 1.5 million patients with chronic obstructive pulmonary disease. Update your knowledge of the disease and its treatment.

Taking it to the top

ANA and state associations promote health system reform The importance of health system reform can seem like a distant memory when gas prices are going through the roof…

Taking the ICU to the Patient

How one rapid response team prevents cardiac arrest and provides other life-saving benefits outside the ICU.

Tap your way to fast relief

Want to reduce physical and psychological stress? Emotional Freedom Techniques may be able to help.

TBI: Closing the care gap in rural areas

Patients with traumatic brain injury (TBI) experience varying symptoms depending on injury severity. Navigating reentry into the community and achieving the highest level of independence requires interdisciplinary planning…

Team-based approach to behavioral health emergencies

Pre-defined roles and training can help address disruptive client incidents. Takeaways: Few hospitals have a formal plan to address combative clients. REACT (Rapport, Escort, Antipsychotics/anxiolytics, Communicate, Times) is…

Telling our story

The public needs a better understanding of what nurses do, so tell your story.

The ABCDEs of emergency burn care

Consider this scenario. You’re driving home from work after a busy shift and there has been an accident ahead on the freeway. As you approach, you see that…

The ABCs of COPD

“I am a 59-year-old female recently diagnosed with Stage 2 COPD and chronic bronchitis. I smoked for 22 years. I have been hospitalized twice in the last seven…

The aging face of HIV/AIDS

People older than age 50 account for at least 10% of HIV/AIDS cases in this country. Yet myths about older adults' behavior can blind us to the possibility…

The beat goes on: A pacemaker primer

With the growing use of cardiac pacemakers, it’s time to refresh your knowledge of pacemaker basics. This article describes types of pacemakers, reviews pacemaker codes, and helps you…

The disappearing inpatient

As hospital admissions shrink, nursing jobs are shiftingto other areas, such as outpatient offices, clinics, postacute facilities, and home care.

The environment and the nurse

We are hearing much talk about the unseasonably warm weather in some areas and extreme conditions in others. Frequently, we hear something about the role of global warming.…

The freeing force of laughter

By reciting wacky dialogue from a scene in a Monty Python movie, Mary Delisle, RN, interrupted the negative thought patterns of a patient mired in dread and dispair.

The genetics of colorectal cancer

A 52-year-old patient arrives at the busy family practice office where you work for his follow-up visit. He had not undergone colon cancer screening, despite his age, but…

The growing threat of cephalosporin resistance

Extensive use of third-generation cephalosporins has led to cephalosporin-resistant bacterial strains. Learn how these organisms cause deadly infections and you can help control their spread.

The healing didn’t stop during Sandy

As Superstorm Sandy ravaged much of New York City, nurses went above and beyond the call of duty. Many jeopardized their own welfare to provide patient care.
unreasonable reasonable important nice standup

The importance of being unreasonable

Nurses, on the whole, are a darn nice group of people. After all, nurses have a reputation for being caring, self-sacrificing, nurturing, hardworking, and honest. So why don’t…
nurse story remembering teach

The little things we do

In December 2001, the graduating class of New York University’s College of Nursing asked me to give a speech during their pinning ceremony. As part of nursing education,…

The magnetic draw of information technology

With a shrinking workforce and more complex healthcare, how can nurses raise the bar on clinical excellence? One hospital uses health information technology to improve efficiency and reduce…
The Maslow effect: A humanist legacy for nursing

The Maslow effect: A humanist legacy for nursing

In the late 1960s, psychologist Abraham Maslow was moved by the kindness of the nurses and nursing students he encountered when hospitalized for heart disease. Curious about why…
Assessing your patient’s oral health

The mouth in the mirror: Assessing your patient’s oral health

Approximately half of American adults have periodontal disease—a chronic inflammatory disease affecting gum tissue and supporting teeth. Longstanding untreated periodontal infections are linked to overall health issues. Especially…

The new health insurance marketplace

Our editor-in-chief discusses the upcoming insurance requirement related to the Affordable Care Act and emphasizes the need for nurses to be knowledgeable about the requirements so they can…

The new normal

Welcome to fiscal austerity—the new normal.

The patient engagement imperative

Engaging patients is essential to ensure optimal reimbursement. Here are tips for engagement that leaders can apply in their organizations

The role of pharmacogenomics in cancer

Oncology nurses have long appreciated that the “one size fits all” strategy—basing chemotherapy dosages on body surface area—for treating cancer does not work because of variations in patients’…

The science of skin peels

Learn how slathering a chemical solution over the face or abrading it with a stream of crystals rejuvenates the skin. This article takes you under the skin surface…

The voice of the consumer

This month, the Centers for Medicare and Medicaid (CMS) begin reporting patient experience data from its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS®) program. The first…

Therapeutic hypothermia after cardiac arrest

Until recently, the outlook for patients who remained comatose after cardiac arrest was dire. But therapeutic hypothermia is turning the tide. Learn the facts about this life-saving approach.
CLABSI

Three practice bundles to reduce CLABSIs

Healthcare-acquired infections (HAIs) remain a significant problem for most hospitals, despite a decade of focused improvement efforts using evidence-based guidelines. One type of HAI, central-line associated bloodstream infection…

Thwarting a pneumothorax

As a patient deteriorates, assessment and history findings guide clinicians to the right diagnosis and interventions.

To make health care better, I would…

To make health care better, I would… …mandate every patient have a primary RN who knows the patient’s past health history, socioeconomic status, health risks, medications, and potential…

To sleep, perchance to heal

Sleep doesn’t come easily for ICU patients. Many suffer chronic sleep deprivation, which can raise stress levels, depress immune responses, and impair wound healing. To help them sleep, some…
Care of Patients on Ventilators

Top 10 care essentials for ventilator patients

In a wide variety of settings, nurses are increasingly likely to care for patients on mechanical ventilators. Let’s assume you’re one of them. What do you need to…

Top post-pandemic global health concerns

The WHO remains concerned about several global health issues, but its focus has shifted since the COVID-19 pandemic. The coronavirus and its consequences have led to the most…

Touch of kindness

Helping a little victim of sexual assault brings a profound realization.
Tracheostomy care

Tracheostomy care: An evidence-based guide

To promote positive outcomes in patients with trach tubes, nurses need to stay up-to-date on best practices and develop and maintain the necessary skills.
Angioedema

Tracing angioedema to its source

Tom Anderson, age 74, was admitted to the telemetry unit yesterday with new onset of chest pain. Melanie, his nurse, notes that his troponin test came back negative,…

Translational perspectives on violence

The United States Department of Labor, Occupational Safety and Health Administration reports that nearly 2 million American workers report being victims of workplace violence each year and that…

Troubling Imagery

“Young children can’t distinguish between reality and fantasy,” says Montoya, president of the National Association of Pediatric Nurse Practitioners (NAPNAP) and a New Mexico Nurses Association member.
TB

Tuberculin skin test interpretations

As required for volunteer work at a local hospital, Monica, a 28-year-old woman, arrives as a new patient at a small community clinic to request a tuberculosis (TB)…

Ultrasound-guided I.V. catheter insertion

Establishing peripheral I.V. access is an essential, high-priority nursing procedure. However, access sometimes can be difficult to obtain even for experienced clinicians. Recently, the evidence-based ultrasound-guided short peripheral…

Understanding MCS

More research is needed to increase our understanding of multiple chemical sensitivity.

Understanding seizures in children

Although seizures are scary for the child, parents, and bystanders, most pediatric seizures can be controlled or eliminated.

Unilateral DIEP flap: Reducing length of stay

Deep inferior epigastric perforator (DIEP) flap procedures use a patient’s own blood vessels, skin, and fat from the lower abdomen to reconstruct a breast after mastectomy. In 2018,…

Unite to Fight the Flu – Influenza Season Update

There is a saying that if you’ve experienced one influenza season, you’ve experienced one influenza season. Influenza is a highly unpredictable virus, and the 2011-2012 season has proved…

Unraveling the enigma of irritable bowel syndrome

Common, complex, and chronic, IBS can markedly decrease the quality of life and work productivity. But by using an integrated approach, you can help patients manage their symptoms.

Urban sprawl and the built environment

Environmental health is in the midst of a paradigm shift. Today, features of the built environment, such as architecture and urban planning, are considered as important to human…

Victory on BPA ban in baby bottles, dishware

On March 3 the Washington State House overwhelmingly passed the “Safe Baby Bottle Act” (SSB 6248), a bill to eliminate the chemical bisphenol A (BPA) from baby bottles,…

Vocal cord dysfunction

A 21-year-old man with a history of asthma and environmental allergies became ill with the coronavirus. Before this illness, he managed his asthma well with corticosteroid inhalers. After…

What HIT means to healthcare professionals

When it comes to health information technology (HIT), every nurses has a stake in—and a piece of—the action. Let’s figure out how to make HIT work for, not…

What is burning mouth syndrome?

You’ve probably have heard of PMS, but what about BMS? Burning Mouth Syndrome (BMS) is a little-known condition that affects some 1.3 million Americans. It most commonly affects…

What works: Reducing falls in the home

Would you like to learn a practical strategy for reducing falls in the home? We are two home care nurses addressed the problem with a creative solution—a pictorial…

What you need to know about bipolar disorder

Extreme mood and behavior swings, disrupted lives, reduced life expectancy, obstacles to getting help—these are among the effects of bipolar disorder. When you understand this condition, you can…
heart

What’s the latest on lipoproteins

A new lab technique called segmented gradient gel electrophoresis identifies subclasses of cholesterol and more precisely predicts your patient’s cardiac risk.

When all signs point to long QT syndrome

A patient’s brief loss of consciousness leads to discovery of long QT syndrome. By thinking fast and making all the right moves, you can stave off the threat…

When asthma escalates to an emergency

In asthma, airway inflammation leads to airway obstruction, which may be chronic or arise as an acute symptom exacerbation. Asthma signs and symptoms range from mild to severe…

When cancer spreads to the bone

Bone metastases causes significant pain and raises the risk of fractures and spinal-cord compression. Learn how to help patients cope.
Tripping over the welcome mat: Why new nurses don’t stay and what the evidence says we can do about it

When good people make hard choices…*

Leah Curtin discusses the difficulty of making choices in health care and includes a challenging situation she experienced as a student.

When it’s my time to die

Failing to make our end-of-life wishes known to others can deny us and our loved ones important choices.

Why making the rounds makes sense

Nursing rounds are making a comeback – but this time, they’re based on research and structured for maximum efficiency.

Workplace programs promote healthy behaviors

Workplace health promotion programs are an efficient approach to improving the health of a relatively large group of individuals because worksite interventions are more convenient and accessible to…

Wound care: Five evidence-based practices

Nurses, physical therapists, physicians, and surgeons perform wound care in almost every care setting; however, evidence-based practices continue to elude many healthcare providers. Five key considerations—clean vs. sterile…

You can help stop the cycle of teen bullying

Bullying refers to repeated negative activity or aggression intended to harm or bother someone that the aggressor perceives as less powerful. In many cases, bullying victims are harassed…

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