Nursing2017 covers the latest news in nursing and healthcare. See what's making headlines this month!

Thursday, February 16, 2017

Love is in the air

February, the month of Valentine's Day and now newly declared American Heart Month, inevitably inspires talk of relationships, love, and heart health awareness. While one of our February CE features focuses on a cardiovascular clinical topic (check out When cardiac tamponade puts the pressure on), this month's Legal Matters warns against the potential danger of an office relationship.

In Beware the perils of an office romance, Kristopher T. Starr explains that an office romance in the clinical setting can have serious negative implications that sometimes trigger legal action, including perceived favoritism, nepotism, preferential treatment, power inequities, and corporate liability.​

The USA Today article Finding love on the job can mean keeping a secret echoes this sentiment. The article reports that while 41% of workers have dated a colleague, only 30% of those relationships ended in marriage. Most office romances end less than happily ever after and sometimes even yield legal entanglements. To prevent these situations from arising, the percentage of workplaces with rules around office relationships has grown from 25% in 2005 to 42% in 2013.  

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Monday, January 16, 2017

E-cigarette use on the rise

On December 8, 2016, the U.S. Surgeon General held a press conference calling attention to the rising use of e-cigarettes in the nation's children, teens, and young adults.

Surgeon General Vivek Murthy, MD, labeled the trend a major public health concern and called on lawmakers to address the issue. According to MedPageToday, e-cigarette use has more than tripled among middle school and high school students since 2011.

In Nursing2017's January feature Escape the vape: Health hazards of the latest nicotine craze, Sally Huey, DNP, APRN, FNP-BC, and Margaret Granitto, MS, ANP-BC, present the latest evidence about these controversial products and review current federal regulations governing their sale and marketing.

Mumps hit a 10-year high in 2016​

On December 13, 2016, CNN reported that the U.S. has seen the most mumps cases in a decade. According to the Centers for Disease Control and Prevention, there were 4,258 reported mumps cases across 46 states and the District of Columbia since December 3, 2016.

Nursing2017's January Combating Infection article, Mumps makes a comeback: What nurses need to know, by Paula Barbel, PhD, PNP; Kathleen Peterson, PhD, RN, PCPNP-BC; and Elizabeth Heavey, PhD, RN, CNM, covers the epidemiology, transmission, complications, treatment, and prevention of mumps. It's a must-read for nurses interested in learning more about this contagious infection! 

Friday, September 9, 2016

Guest editor Joyce Hislop, AD, RN, is a freelance writer in Breinigsville, Pa.

Anxiously, I answered the firm knock on my father's kitchen door.

At 1 p.m., the nursing agency had called to say they were scrambling to replace the previously scheduled evening aide for my father. A retired nurse myself, I understand schedule frustrations. My dad needed assistance for the day and evening shifts 7 days a week. Of his five adult children, my youngest brother and I lived locally and did what we could, but we each had work obligations. Our dad had agreed to hire an agency to provide home health aides during day and evening hours; our brother covered any late night needs, and our sister JoAnne drove from upstate New York for the weekends.

Standing in the doorway, a tall, stunning woman with a wide smile put her hand toward me in a friendly greeting, at the same time offering an apology. I'll call her Sandra.

"Hi, I'm Sandra, from the agency. So sorry to be late- I didn't anticipate all the traffic lights along the highway and I managed to hit them all!"

The agency had sent us yet another new aide. Sandra was in her 30's, and she looked like a runway model, draped in a gracefully flowing skirt in muted colors of turquoise. The color suited her grey eyes and shoulder-length dark hair. I had to admire her presentation.

Our introductions made, Sandra followed me toward my dad, who was watching and listening from his red leather chair in the middle of the large kitchen. Sandra confidently stretched out her hand to him and smiled broadly, repeating her name in case he had not heard clearly.

"I love your kitchen," she said, and he beamed. In better days he had liked to cook and appreciated any notice of how the kitchen reflected that interest.

"Perfect," I thought, listening to the two chat for a minute about the baker's rack filled with his favorite cook books and shiny pots. The slight Southern drawl in the aide's voice was both charming and soothing.

I showed Sandra where to put her purse and pointed out the phone and emergency contact list. My main concern was that she use good body mechanics to get him up from sitting or lying down: He was a tall man and weak after several months of dialysis. I asked Sandra if she'd mind demonstrating how she'd help him up from his chair.

"Why, sure!" she replied, and squared herself in front of him. In just a couple seconds he was on his feet, looking somewhat surprised at the power behind the position change.

"As long as I'm up, I might as well go in there," he said, and motioned toward the bathroom. Sandra's steps matched his as they slowly moved the short distance. Allowing him privacy in the handicapped bathroom, she stood by the closed door and waited for his call. I gathered my jacket and bag, telling Sandra that our sister was coming in for the weekend and she'd arrive tonight in plenty of time for the shift change. I could see that Sandra and her charge were comfortable with one another and it would be okay if I left.

About 9 the next morning I got my sister's update on Sandra's shift.

"So, Joyce," she began, exaggerating a laid back and casual tone.

Oh-oh. Her tone was leading up to something.

"Is everything okay?" I was afraid to ask.

JoAnne assured me that our dad was fine. She went on to tell me she'd arrived at the house about 9 p.m. Dad was having his usual evening issues with restlessness, alternating between the kitchen and his hospital bed in the living room. Sandra had just settled him back to the bed; it seemed they'd both had a relatively uneventful evening. JoAnne went into the living room to say hello and goodnight to Dad and then came back to the kitchen. Getting a snack, she offered Sandra the same. A cup of coffee and conversation led to the discovery they had mutual friends, and during a second companionable cup Sandra shared a personal confidence: 'Sandra' was really Samuel; her biological gender was male. Through her elementary and high school years she'd rejected the gender assignment she'd been given at birth and had never felt comfortable having to live as a man.

This revelation was astonishing to me. The quality of care Sandra provided had been excellent, and Dad had even suggested that Sandra become one of his regular aides. However, my father, at age 78, might have seen it as a deception. If he'd known Sandra was born male, I believe he wouldn't have understood her choice to live, behave, and dress as a woman.

This encounter happened nearly 20 years ago. It was a different time, before terms like gender dysphoria and transgender were common. With a society more open to different expressions of gender identity,1 I wonder how this situation would play out in today's world.

How would you have handled this situation?


1. Pitts L. Human dignity gets an important boost. The Morning Call. July 3, 2015.​

Tuesday, August 23, 2016

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Guest writer Ellen Zimmerman, MSN-Ed, RN, is a former faculty program director in the ADN program at Excelsior College in Albany, N.Y. and online adjunct faculty at Excelsior College and the CUNY School of Professional Studies in N.Y.

"I can't ever imagine you crying at work!"

This simple statement, made by a former nursing student, made me stop and think. As an RN of almost 40 years, my immediate reaction was "Of course I have."

Here I was, a faculty member with years of experience, and I was immediately brought back to the fears, anxieties, and insecurities I experienced when I was a new nurse. I thought very carefully before I typed my response to her. Is it ok to cry? Yes. But it's not OK to cry so hard you can't keep doing your job.

I told her we cry because we're human, and because we care. If you lose that passion, that commitment, then you've lost the essence of what makes us caring individuals.

I've been a new graduate, staff nurse, charge nurse, supervisor, and nursing faculty. Most of my career has been in critical care and emergency where life and death hang in suspension on a daily basis.

I cried when a child was brought to the ED, who'd died from a broken neck after being hit by a car. I've cried while holding the hands of dying patients as they took their last breath. Tears flowed at work when I learned that a valued coworker had succumbed to her metastatic cancer. I wiped away tears watching the birth of a baby with my nursing students. I cried behind the closed door of my office after informing a student that she wasn't successful, and would have to leave the nursing program despite her hard work.

But I didn't cry when it was time to leave the ED. I always went with the physician to inform families about the result of our resuscitative efforts. My last evening was no different. We'd just finished yet another code and I stood there while the sad news was delivered. I'd always found it impossible to stand there without my eyes filling up with tears.

This time I felt nothing! I went through all of the motions, but my own emotion was gone. I was caring, compassionate, and helpful to the family, but I felt absolutely nothing.

I knew in that moment that I wasn't the critical care nurse that I was when I started. I knew deep in my soul that I needed to leave and find my passion again. I finished my BSN and my MSN and started teaching. It's my true passion, and I can impart my years of experience to others. I make a point to teach not only curriculum, but the caring as well.

So my young graduate, please do not worry about crying at work. It's because you care, you're passionate, and you want to make a difference. Never lose that despite the crazy, overwhelming shifts, long hours, exhaustion, short staffing, and school work. Keep your focus and keep caring, and if your eyes fill up with tears now and then--trust me--it's OK.

Wednesday, August 3, 2016

Guest writer Alison Cody, BSN, RN, CHPN, is a case manager at Providence Hospice in Portland, OR.

Eunice had the best yard in the neighborhood--where all the children on the block played hide and seek. She had huge, wide trees and the children liked to hide in them. This is one of the first things she told me, her hospice nurse, on my first visit to her house. Eunice loved to watch the neighborhood through the large picture window in her living room. Eunice wanted me to listen; she wanted to tell me her story. She was looking for a safe space to talk things through without judgment.

Eunice invited me along on her journey and she was the one driving the bus. As a hospice nurse, I'm often given the privilege of being one of the passengers on board. My role is to help navigate a path that can be uneven and often cluttered with debris. The path may have forks in the road--and although I can offer expertise on which path to take, they all ultimately lead to the same destination.

Eunice had been diagnosed with a recurrence of her lymphoma. She had a new tumor on her spine that caused increasing pain in her right leg and back. This diagnosis came after Eunice awoke one day about 2 weeks before we met and was unable to get out of bed. She was unable to stand or walk; her disease was advanced, and she was too frail to undergo chemotherapy. She elected not to pursue palliative radiation that may have lessened her pain, and chose hospice care instead. She required full-time care and needed assistance with her activities of daily living.

On that first day with Eunice, I invited her to tell me what was most important to her, to share what brought her joy. She answered me from her bed in the living room where she had a view of her front yard. She told me she wanted to walk, or at least get out of bed and sit in her wheelchair. She hoped that maybe she could feel her leg again. Eunice shared stories of her radiation treatment and how she never wanted to do that again. She admitted she was in a great deal of pain, but didn't want to become addicted so she took her pain medication only at night.

I had many nursing visits with Eunice where she talked and I listened. Sure, I provided nursing care, did dressing changes, filled her medication box, and adjusted her pain medications as she would allow, but my time with Eunice was much more than simple nursing care. I could've spent my visits doing the talking and trying to persuade Eunice to do things a certain way. But that wasn't why she had invited me in. It wasn't my right to determine what defined quality end-of-life care for Eunice. I wasn't in charge, Eunice was. In healthcare, we sometimes need to remind ourselves that we aren't the ones driving the bus!

In time, Eunice decided she was ready to be in less pain and changes were made that accomplished this, including an increase in her pain medication and starting anxiety medication. She allowed the other members of my team to board her bus and ride along with us. She even had a period of a few days where she was able to sit in her wheelchair. She drove the bus until the very end. When Eunice could no longer speak, I still knew how to help her drive. I knew because I listened. I met Eunice where she was, not where I wanted her to be.

Eunice died 6 weeks after she enrolled in hospice. It was an honor to provide care for her, and even more important, to be her passenger.