[LEGISLATIVE] State of the Union for Nurses

“Because of this law, no American can ever again be dropped or denied coverage for a preexisting condition like asthma, back pain, or cancer. No woman can ever be charged more just because she’s a woman.” –President Barack Obama, January 28, 2014

This past Tuesday, President Obama gave his annual State of the Union. Millions of Americans across the country tuned in to hear the President’s speech. Some Americans were jumping to their feet in applause and others yelling at the flickering screen in front of them.

Thank you to all the awesome RNs who followed @RNAction on Twitter that evening. We encourage you to continue to tell us how the ACA impacts you and your thoughts on the State of the Union address. Here’s the response from ANA’s President Karen Daley.

In response to President Obama, Congresswoman Cathy McMorris Rodgers (R-WA) gave the official Republican response. Did you hear that nurses were specifically mentioned?

“Every day, we’re working to expand our economy one manufacturing job, nursing degree and small business at a time”

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Vesicants: not just chemo agents!

Infusion Nurse Blog

There is no doubt that several chemotherapeutic agents have vesicant properties, and when inadvertently infused into the surrounding tissue from an infiltrated IV, these agents may have the potential to cause blisters, severe tissue injury or necrosis, known as extravasation. The damage to the tissue can occur from direct contact with the vesicant medication, from compression of surrounding tissues by a large volume of fluid or from severe vasoconstriction.

But chemo agents are not the only vesicants that cause extravasation injuries. There are non-chemo medications and solutions that have vesicant properties as well and can cause extravasation. Listed below are a few non-chemo agents:

  • Vancomycin
  • Nafcillin
  • Calcium Chloride
  • Potassium Chloride
  • Sodium Chloride
  • Calcium Gluconate
  • Dobutamine
  • Diazepam
  • Dopamine
  • Norepinephrine (Levophed)
  • Phenytoin (Dilantin)
  • Promethazine (Phernergan)
  • Propofol
  • Vasopressin
  • Radiologic contrast agents

The incidence of extravasation from these non-chemo agents is unknown perhaps due to under reporting but there is an increasing number of…

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[OPPORTUNISTIC LEARNING STRATEGY] Pharm-mercials & Pharm-marketing

ImageThey’re everywhere.  You’ve seen them, ignored them, recycled them and changed the channel on them.  They… are pharmaceutical ads.

Pharmaceutical companies spend exponentially more money and other resources on medico-marketing then they do on research.  Over $57 billion per year (that’s billion, with a “b”) in 2005.  “Pharmarketing” is highly controversial.  However, it’s ubiquitous nature can be a beneficial to the opportunistic student. 

When a moment (or ad) presents itself, read, or listen up.  Review the drug trade and generic name, side effects, contraindications… Repetition via different media, at different times, in varied locations reinforces learning and memory. 

Another benefit?  Some of the most frequently prescribed drugs and those that are being pushed out the hardest by pharmaceutical companies are the meds in the media that also end up in your med pass. In nursing, learning must be continual to stay up to date on changes and advances in evidence based practice, in protocol, in research… New developments  arise every moment of every day.  Creating a habit of catching learning opportunities can be a powerful tool to keep in your nursing bag throughout your career as a nurse. 

So next time a pharm-mercial pops on, or a full-page magazine ad presents itself; listen up, give it a quick scan and solidify your learning on-the-go!

[HEALTH POLICY BLOG] Pay & Practice

Pay and Practice: Birth Control Cases Advance 
 

The Supreme Court’s consideration of the Affordable Care Act’s contraceptive coverage mandate may be several months away, but lower courts continue to hear various challenges. Pay and Practice is a blog for readers interested in health policy.

http://www.medpagetoday.com/Washington-Watch/Reform/43621?xid=nl_mpt_DHE_2014-01-02&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g570633d0r&userid=570633&email=heather.c.swift@gmail.com&mu_id=5696231

[LEGISLATIVE ADVOCACY] Nurses Speak Up About Rape in the Military

In 2012, 3,374 brave men and women in our military reported an incident of sexual assault.

It is estimated that 26,000 sexual assaults happened in our armed services last year.

This means only an abysmal 13% of cases in the military are reported, compared to 40% reported in civilian cases.*

Why the discrepancy?

The issue of reporting in the military is complicated but heightened awareness with skilled professionals and targeted programs will increase the likelihood of reporting.

We believe, sexual assault nurse examiners (SANEs) are an integral part of the solution.

The National Defense Authorization Act (NDAA) would establish training requirements for sexual assault nurse examiners (SANE) performing examinations of victims in the military. Introduced by Senator Barbara Boxer (D-CA), these provisions would ensure SANEs be available at every military facility so that victims receive an examination within 24-hours of an assault. ANA along with twelve other health organizations sent a letter to Senator Boxer expressing support for this amendment.

It is time for you to ensure victims of sexual assault have access to safe, quality examinations. Please write your Senator and ask them to include the Boxer amendment today.

https://secure3.convio.net/ana/site/Advocacy?cmd=display&page=UserAction&id=435

Watch: The Invisible War:  http://invisiblewarmovie.com/

[NURSE ADVOCACY] The ANA Forges Forward Through Action

takeawareness2action

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It was difficult to see important programs forced to shut down and hard working Americans struggling to get by. With all the political discussion and commentators each saying something different it was hard to hear authenticity in the midst of all the debates.  One thing was clear; Nurses’ voices were rising above the noise.

Over 1,000 nurses took action and wrote to their member of Congress last week—thank you.

Phew. We are relieved that politicians have come together and reached a deal to end the fiscal impasse. Government will be funded through January 15 at sequestration levels and the debt limit extended until February 7.

Now is when the real work begins. Don’t let the action stop here! Share your activism with friends and help recruit new support for nursing issues – all from within Facebook!

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Sometimes the Best Thing You Can Say is Nothing

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Sometimes the Best Thing You Can Say is Nothing

We need to find God, and he cannot be found in noise and restlessness. God is the friend of silence. See how nature – trees, flowers, grass- grows in silence; see the stars, the moon and the sun, how they move in silence… We need silence to be able to touch souls.

~Mother Teresa

Being Teachable is the First Key to Learning

Be Willing to Admit Ignorance, So You Can Learn

Very few people seem to be comfortable with admitting that they don’t know something. Maybe they feel that admitting ignorance about a subject will make them seem stupid, so they’ll feign knowledge and attempt to go with the flow in any given situation. This is highly detrimental on many counts, from a person being seen as an insufferable know-it-all, to projects going awry because an employee claimed to know something they didn’t.

If you don’t know something, admit to your lack of knowledge, and then immerse yourself in the subject so that you familiarize yourself with it. The universe is full of things that we don’t know, but the only way to grow and change is to open ourselves to opportunities to learn… and those won’t come about if we don’t leave space for them by saying “I know” to everything.

Human Connection in Oncology: The Importance of Empathy in Nursing Care

When contemplating social events, we will commonly ask each other, “Are you going to be there?” We like to know that individuals whom we enjoy will likely be present at the same events. When we anticipate life events that have uncertainties to them, we like to know that someone whom we trust and who we have reason to believe cares about us, will be in the life event with us. Treatment for cancer is one of those life events. Patients want to know who will be there with them. Patients are most assuredly interested in the forms of treatment available to them, but they especially want to know that they matter to others, including those who are administering their cancer treatment. Part of what makes an oncology nurse’s care effective is the nurse’s willingness to be there with a cancer patient, to connect with and care about the patient and about the patient’s life and illness. This human connection between an oncology nurse and a cancer patient and the patient’s family is now being identified in studies as what is most memorable about treatment and what is most sustaining to families whose family member did not survive the disease. Patients and families describe oncology nurses with adjectives including kind, supportive, informative, and trustworthy.1-3 What is it about the oncology nurse and the nurse’s care that is so sustaining to patients or to their survivors that it is reported as a source of comfort by patients and families for years after the actual care experienced?

Fortunately, what patients and families refer to is the most common of all elements of oncology nursing care: the human connection. This connection is the interface between nurse and patient; nurse and family members; nurse and other clinical care team members; nurse and ideas about care; and between the nurse and self-images, including self-compassion and forgiveness. A desire to form human connections is a motivation for becoming an oncology nurse; the human connection between the oncology nurse and the patient and family can offset difficult relationships with peers, disappointments with leaders, and even the irritations of inconsistently available resources and supplies for care.4 The disappointment in self for not being able to form such connections well (or to be there for patients and for families) has been one of the reasons for oncology nurses choosing to exit oncology nursing. This human connection between the oncology nurse and the patient and family is sustaining for the patient, the family, and for the nurse and is a treatment intervention. Amazingly, we know some of the outcomes of the human connection as a treatment because of patient and family reports, but we do not know the critical components of this human intervention in fine detail or the factors (environmental, personal, professional, or clinical) that influence the ability of the oncology nurse to deliver this treatment.

There is no form of mainstream cancer treatment (chemotherapy, radiotherapy, surgery, biotherapy) and no level of cancer prevention that is unaffected by the human connection between the oncology nurse and the patient or family. Cancer treatments have focused increasingly on the smallest elements of the human body (ie, genes, polymorphisms), but the usefulness of these smallest elements in cancer treatment will be dependent on oncology nursing care and the human connection between the oncology nurse and the patient. To be effective, treatment needs to be acceptable, understandable, and described in a way that resonates with patients’ life priorities. The acceptability of treatment relies on the ability of the oncology nurse and that of other clinicians to make a human connection with patients such that we can prepare them well for the experience of treatment in terms of what it could mean for their lives.

When we reflect on the human connections in our oncology nursing practice, our reflections include clinical interactions that were remarkably positive (the peak experiences) or memorably negative (the nadir experiences). The emotion that accompanies these reflections can be powerful enough that we reexperience the emotion with the recalled memory and move quickly and with purpose to end the reflection and instead focus on the next life event. By suppressing the memory and the emotion and moving doggedly to the next life event, we miss a sure chance to learn from ourselves the mystery of how it is that oncology nursing makes the human connection with patients and their families that proves to be the sustaining, memorable part of treatment. Instead of not attending and analyzing the human connection, let us study this element of our practice that gives such sustenance to others as well as to ourselves. How and when are such human connections made? What are the patterns across such human connections? What are the common elements in these connections, and are they common enough that they could be titrated to benefit different patient situations? How are these human connections maintained between a nurse and a patient? What environmental, personal, professional, or clinical factors influence the human connection in positive or adverse ways? The human connection in oncology nursing needs careful study, but in the interim we will continue to be there for oncology patients and their families, for our colleagues, and for ideas that will improve our care.

 

References

1. Zamanzadel V, Azimzadeh R, Rahmani A, et al. Oncology patients’ and professional nurses’ perceptions of important nurse caring behaviors. BMC Nurs. 2010;9(10). http://www.biomedicalcentral.com/1472-6955/9/10. Accessed November 14, 2010. [Context Link]

2. Masood J, Forristal H, Cornes R, et al. An audit of patient satisfaction with uro-oncology nurse specialists-a questionnaire study. Int J Urol Nurs. 2007;1(2):81-86. [Context Link]

3. Van Rooyen D, le Roux L, Kotze WJ. The experiential world of the oncology nurse. Health SA Gesondheid. 2008;13(3):18-30. [Context Link]

4. Steen B, Burghen E, Hinds PS, et al. Development and testing of the role-related meaning scale for staff in pediatric oncology. Cancer Nurs. 2003;26(13):187-194. [Context Link]