New and Noteworthy
A forum for discussion on recent news and developments in healthcare and the NP field.
Tuesday, April 12, 2016
Federal authorities have disclosed that they are looking to revamp marijuana's classification, which could have a massive effect on the plant's medical use. Listed as a "Schedule I" drug, marijuana is currently classified in the same category as heroin, ecstasy, methaqualone, and bath salts.
The DEA is looking to reclassify marijuana to a Schedule II drug, placing it alongside OxyContin, Percocet, Adderall, and Ritalin. Medical professionals are saying that this change could loosen research restrictions, thus leading to a more comprehensive understanding of marijuana and how it can be used to help patients.
"Current standards for approval of prescription drug products require rigorous scientific study. While studies related to a limited number of medical conditions have shown promise for new cannabinoid-based prescription products, the scope of rigorous research needs to be expanded to a broader range of medical conditions for such products," the AMA said in a statement.
Dr. Kevin Hill, assistant professor of psychiatry at McLean Hospital and Harvard Medical School, pointed out that there are roughly 60 known compounds in marijuana that have not been studied extensively for medical purposes. What are your thoughts on this reclassification?
[Via ABC News]
Friday, February 26, 2016
By Lisa Abel, MSN, WHNP-BC, ARNP
“It’s hard being a nurse practitioner.” This is a quote from a former student of mine. She has been in practice for about two years and was expressing her frustration with making the transition from registered nurse (RN) to advanced practice registered nurse (APRN) with a Doctor of Nursing Practice (DNP) degree. Role transition is an experience that each of us can relate to, and the associated stress caused by this transition may have us doubting our preparedness and skill level.
I remember those feelings of doubt as a new APRN graduate and would carry around a pocket-sized notebook that contained a list of medications and practice protocols that I could refer to just in case. I knew the right course of action, but I needed that added security. The pocket-sized notebook, of course, is my generation of nurse practitioners (NPs). Today, the information would be accessed through our smartphones.
A stepping stone to the DNP degree
After discussing with my former student, it was clear to me that those of us who completed our Master’s degree first (before advancing our degree further) may have an advantage over the new generation of NPs who will graduate directly with a DNP. The Master’s degree offered us a stepping stone, giving us time to refine our newly-acquired skills and adjust to our new role. Future NPs will not have this gradual transition. In addition to functioning in an advanced role, the DNP is expected to have advanced leadership skills. I am concerned about this added expectation along with the heavy work burden that future APRNs will experience. This burden includes the healthcare provider demands that the Affordable Care Act 1 has brought to the nursing profession.1-3
How will APRNs become comfortable with their new skills and be expert leaders? We need to maintain the quality of care that NPs have always provided. Will our burden be too great and affect this quality? These are questions and valid concerns that I know many of us are asking. The time is now for APRNs to stick together and lean on each other. Those of us who have been in practice for years need to provide support and encouragement to our newer colleagues. The Institute of Medicine proposed a nurse residency to assist new graduate RN/APRNs transitioning to the work environment.2 These programs have been slow to fruition, but there are role transition theories that may help guide us.4,5
I am drawing from my experience as a clinical preceptor and propose a few interventions that can assist with the new graduates’ transitions. First, share your transition experiences when you were a new NP. Show your human side, and emphasize that it is normal to feel anxious in a new situation. Second, acknowledge that even after years of practice, you are still learning. I cannot tell you how many times I have had a student ask me, “How long will it take me to learn everything?” Oh, how I wish some days that I knew everything! Perhaps it is a perception because of our sometimes litigious society that we need to know everything upon graduation, but it is just not possible.
The APRN certainly needs to be well trained to practice safely, but all of us should be continually learning in our area of specialty. We should not be afraid to let our new colleagues know that expanding their knowledge and honing their skills is a part of the normal evolving process for the APRN. I know that my many years of experience have made me a better NP then I was at graduation.
Keeping in touch
Lastly, if you are a clinical preceptor, make a point to touch base with your students after graduation to see how they are doing in their new position. This is especially important for those graduates who do not work with other APRNs. If you have a new APRN in your practice setting, make yourself available for questions, consults, and support. Emphasize that although transition is difficult, there is an end point. If possible, encourage the new APRN to limit other simultaneous life transitions.
As APRNs, we need to stand united. This means supporting and helping each other professionally. It means taking the time to assist new APRNs in their role transition. This support will ultimately keep our profession strong and help keep us well qualified to care for our patients.
1. U.S. Department of Health and Human Services. Affordable Care Act. http://www.hhs.gov/healthcare/rights/law/index.html.
2. The future of nursing: Leadership change, advancing health. http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Change-Advancing.Health.aspx.
3. Poghosyan L, Lucero R, Rauch L. Berkowitz B. Nurse practitioner workforce: A substantial supply of primary care providers. Nurs Econ. 2012;30(5):268-274,294.
4. Duchscher JE. Transition shock: the initial stage of role adaptation for newly graduated registered nurses. J Adv Nurs. 2009;65(5):1103-1113.
5. Benner P. From novice to expert. Am J Nurs. 1982;82(3):402-407.
Lisa Abel is a nurse practitioner at Overlake Obstetricians and Gynecologists, Bellevue, Wash.
The author has disclosed that she has no financial relationships related to this article.
Thursday, February 18, 2016
Pregnant Latin American women are scared of giving birth due to the recent Zika virus outbreak. These women are now seeking abortion pills (with varying legality in Brazil, Colombia, Venezuela, Peru, and El Salvador) from Women on Web, a Canadian group for women seeking abortions where the procedure is banned. Some of the mothers have already tested positive for Zika, and others are worried that they will contract the virus, which causes microcephaly.
“Probably a lot of women are looking for abortion services now. Women that are pregnant and suspect that they have had Zika and they just don’t want to take the risks of having a microcephalic baby,” Women on Web founder Dr. Rebecca Gomperts said. “Our worry is that these women will turn to unsafe abortion methods, while we can help them with a safe medical abortion.”
Women on Web, founded in 2005, has been providing Mifepristone and Misoprostol to women globally for over a decade. The number of Brazilian women contacting the organization has jumped from 100 in the first week of December to 285 in the first week of February.
[Women on Web]
Wednesday, February 3, 2016
The Zika virus has been steadily spreading over the past several weeks in South and Central America, and to a lesser extent, in the Commonwealth of Puerto Rico and the U.S. Virgin Islands. The virus, which is spread via the bite of infected mosquitos, shows symptoms in roughly 1 in 5 people. Zika is rarely fatal, and common symptoms include fever, rash, joint pain, and conjunctivitis.
Zika is particularly dangerous to pregnant women, as the virus can spread from the mother to her baby, causing possible birth defects (such as microcephaly) if infected during pregancy. The best prevention method is to prevent mosquito bites by wearing long-sleeved shirts and long pants. EPA-registed insect repellants should also be used as directed as well as permethrin.
Update: "Until we know more, if your male sexual partner has traveled to or
lives in an area with active Zika virus transmission, you should abstain
from sex or use condoms the right way every time you have vaginal,
anal, and oral sex for the duration of the pregnancy," the updated
guidance says. Dallas County, Texas, health officials announced that the virus had been spread via sex with someone who recently returned from Venezuela infected with Zika. This marks the first known case of virus being acquired in the continental U.S.
Wednesday, September 16, 2015
Kelley Johnson, a 22-year-old nurse from Windsor, CO broke the mold during the Miss America tournament's talent portion when she spoke about caring for an Alzheimer patient (Joe) instead of performing a typical song/dance routine like many others.
Dressed in scrubs and tennis shoes, Johnson detailed how she grew close with Joe and how they each helped each other realize that they're more than just a diagnosis or a career. "You are not just a nurse. You are my nurse. And you have changed my life because you have cared about me," Johnson quoted her patient.
Johnson went on to say that people are people before anything else. "I'm never going to be just a nurse," she concluded.