NursingCenter.com

NursingCenter’s In the Round

A dialog by nurses, for nurses
NursingCenter.com

Suicide assessment – an important nursing responsibility

clock August 20, 2014 09:09 by author Lisa Bonsall, MSN, RN, CRNP

As we continue to mourn the loss of Robin Williams, an iconic entertainer and comedian, it’s important for us to take a step toward learning from his death. As nurses, our responsibilities to our patients are numerous, but we know that safety is a number one priority. Even if we don’t routinely care for patients with mental illness, patients that we encounter may have a mental illness of which we are unaware. Some patients may have an undiagnosed or newly diagnosed disorder that may increase their suicide risk, whether due to its pathophysiology or its impact on quality of life. In nursing school, we learned about suicidal ideation and how to do a suicide assessment. I’d like to share some resources from our journals with you to revisit this important topic.

 

Assessing patients for suicide risk
Nursing2010 

Suicide Prevention in Neurology Patients: Evidence to Guide Practice
Journal of Neuroscience Nursing

All along the watchtower: Suicide risk screening, a pilot study 
Nursing Management

As If the Cancer Wasn't Enough... A Case Study of Depression in Terminal Illness
Journal of Hospice and Palliative Nursing

Additional Resources
American Foundation for Suicide Prevention
National Alliance on Mental Illness
U.S. Department of Health and Human Services – Directory of support groups



Read these award-winners!

clock July 3, 2014 01:33 by author Lisa Bonsall, MSN, RN, CRNP

Last month, 21 Apex Awards were presented to journals published by Lippincott Williams & Wilkins. These awards are based on “excellence in graphic design, editorial content and the ability to achieve overall communications excellence.” The award-winning articles from our nursing journals are listed below. We are very proud to share them with you!

Shining a Light on Hoarding Disorder
Nursing2013

Responding To an Active Shooter and Other Threats of Violence 
Nursing2013

25th Annual Legislative Update: Evidence-Based Practice Reforms Improve Access to APRN Care 
The Nurse Practitioner: The American Journal of Primary Health Care 

The Hard Truth about Human Trafficking 
Nursing Management

IT Extra: Technology Management Strategies for Nurse Leaders  
Nursing Management

Smart Management: Recruitment And Retention: How To Get Them And How To Keep Them
OR Nurse 2013

Smart Management: High reliability Organizations: An Idea Worth Pursuing 
OR Nurse 2013

Smart Management: Build Your Staff's Leadership Skills 
OR Nurse 2013

Managing Patients with Severe Traumatic Brain Injury
OR Nurse 2013

Editorial: A Grassroots Movement Sounds the Call 
American Journal of Nursing



Cover Image from January 2014 issue of American Journal of Nursing


January 2013 issue of Nursing2013 Critical Care



Technology and Global Health: A Nurse Presents For the U.N.

clock June 19, 2014 10:22 by author Lisa Bonsall, MSN, RN, CRNP

On May 16th, Dr. Anne Dabrow Woods, Chief Nurse of Wolters Kluwer Medical Research and the publisher of American Journal of Nursing and Joanna Briggs Institute (JBI) at Wolters Kluwer, was a special guest speaker for the United Nations and the World Health Organization on “E-health: Using Technology to Improve Global Public Health” during the Global Classrooms® International Model United Nations 2014. In attendance at the three-day conference were 2,300 students from more than 20 nations. The event was held at United Nations Headquarters and the Grand Hyatt Hotel in New York City.

During her presentation, Anne discussed the importance of access to evidence-based practice resources from global collaborations such as JBI and exposed future policymakers to the principles of evidence-based practice. Anne fielded over 20 delegate questions, including the impact of "Big Pharma"  policies on global health, ensuring clean water, food and sanitation as foundations for health in developing nations, and how new technologies, such as apps and robots, are changing healthcare practice today. 

Submitted by:
Janet Feeney
Senior Marketing Manager
Medical Research
Wolters Kluwer



Celebrate Nursing 2014: Part 2

clock May 30, 2014 07:44 by author Lisa Bonsall, MSN, RN, CRNP

I hope that 2014 has been a good year so far! It’s hard to believe we are heading into June soon and it's time to look ahead to nursing recognition days, weeks, and months for the second half of the year. (You can see what we’ve already celebrated this year in Celebrate Nursing 2014 Part 1).  

Vascular Nursing Week
June 8-14 

National Time Out Day
June 11  

37th Annual National Nursing Assistants Week
June 12-19  

Healthcare Risk Management Week
June 16-20  

National Nurses in Staff Development Week
July 15-19

National Pediatric Hematology/Oncology Nurses Day
September 8  

Nephrology Nurses Week
September 14-20 

National Neonatal Nurses Day
September 15  

Gerontological Nursing Week
September 28-October 4  

National Midwifery Week
October 5-11 

Emergency Nurses Week
October 5-11 (Emergency Nurses Day is October 8) 

National Pediatric Nursing Week
October 6-12 

National Case Management Week
October 12-18  

National Hospice/Palliative Care Month
November 

Urology Nurses and Associates Week
November 1-7  

Medical-Surgical Nurses Week
November 2-8 

Emerging Nurse Leaders Week
November 2-8 

Perioperative Nurses Week
November 9-15 

National Nurse Practitioner Week
November 9-15 

Forensic Nurses Week
November 10-14 

Remember to celebrate yourselves and your colleagues! 



The ‘Threat’ of NPs: An NCNP 2014 Wrap-Up

clock May 5, 2014 07:19 by author Lisa Bonsall, MSN, RN, CRNP

It’s been a little over a week since the National Conference for Nurse Practitioners in Chicago, and I am reviewing my notes and reminded of the learning and networking that took place during the conference. On my very first page, from the Welcome and Opening Remarks of Conference Chairperson, Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, SCP, FAAN, DCC, I had written the following: 

I remember this point vividly, as Dr. Fitzgerald had commented that years ago, when our numbers were much smaller, not too many people had an issue with nurse practitioners practicing to the full extent of our education and training. Now however, as there are over 180,000 nurse practitioners, the power of our numbers is threatening to many, even despite recent research demonstrating our value in patient outcomes and satisfaction. This point is incredibly evident in this recent Op Ed piece from The New York Times, Nurses are not Doctors, where the author cites a study from 1999 to support his opinion, which is clearly not the most up-to-date, best available evidence. Have you read it? I encourage you to do so when you are sitting down, because it did bring out a bit of my temper. Rest assured that some leaders in nursing did reply with some Letters to the Editor and you can read them here

And now back to some take-aways from NCNP…

*The states with the least restrictive NP regulations see twice as many patients as those in other states.
Carol L. Thompson, PhD, DNP, ACNP, FNP, FCCM, FAANP
Keynote Address: Awesome Practiced Daily

*Don’t use an ARB and ACE inhibitor concomitantly to treat hypertension.
Joyce L. Ross, MSN, CRNP, CLS, FNLA, FPCNA
JNC-Late: A Focus and Update on the Long-Awaited Hypertension Guidelines

*Not all infected patients are febrile and not all febrile patients are infected.
Lynn A. Kelso, RN, ACNP-BC, FCCM, FAANP
Acute: Fever of Unknown Origin in Adults

*If a patient has an inappropriate tachycardia related to his elevated temperature, consider pulmonary embolism as the cause.
Lynn A. Kelso, RN, ACNP-BC, FCCM, FAANP
Acute: Fever of Unknown Origin in Adults

*Sepsis doesn’t kill patients; multisystem organ failure resulting from sepsis does.
Sophia Chu Rodgers, ACNP, FNP, FAANP, FCCM
Acute: Understanding the Latest Sepsis Guidelines

*If a patient has kidney injury, used unfractionated heparin for DVT prophylaxis.
Sophia Chu Rodgers, ACNP, FNP, FAANP, FCCM
Acute: Understanding the Latest Sepsis Guidelines

*Our patients give us very important information, if we listen!
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*If a patient has loss of the hair that makes up the outer eyebrows, think hypothyroidism. 
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*The presence of pulsus paradoxus is a sign of cardiac tamponade, but can also be seen in severe asthma.
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*To assess judgment in patients with traumatic brain injury, ask “What would you do if there was a fire in your kitchen?”
Tracey Andersen, MSN, CNRN, FNP-BC, ACNP-BC
Neuro Assessment and Diagnostic Work-up for Advanced Practitioners

Thanks for reading this wrap-up! Want to see photos from the event? Here’s our album – enjoy! 



The American Nurse Project

clock April 25, 2014 01:25 by author Lisa Bonsall, MSN, RN, CRNP

During a discussion with several nurses last night, we acknowledged the importance of nurses having a passion for the profession, and how this passion makes a difference in patient care. When I view the trailer for The American Nurse: Healing America, I feel the passion in the voices of those nurses featured. I can only imagine the impact that viewing this entire feature documentary will have. It premieres during National Nurses Week and I am really looking forward to seeing it! 

In 2012, Carolyn Jones, a photographer and filmmaker, traveled across the United States documenting the work of nurses. Her book, The American Nurse, was published that year and includes portraits, interviews, and biographies of nurses she encountered on her journey. An interview with Jones reveals her passion for this project, despite not being a nurse herself. She states, “Nursing is real. I'm fascinated by how a nurse can help all different people, even people that have committed terrible crimes, with the same compassion that they can treat a friend.” She learned a lot during her conversations with nurses and her journey is bringing our important work into the eyes of the public. For that, I am grateful. 

I will leave you with this powerful quote from the mission of The American Nurse Project: 

“At some point in our life each of us will encounter a nurse, whether it be as a patient or as a loved one. And that one encounter can mean the difference between suffering and peace; between chaos and order. Nurses matter.

I hope that many of you will get the opportunity to see this film. You can find a list of theaters here. I look forward to hearing what you think! 



The Rise of the Nurse Practitioner

clock April 3, 2014 16:36 by author Lisa Bonsall, MSN, RN, CRNP

This infographic was shared with us by Maryville University’s Nursing Program

 



Nursing2014 Symposium

clock March 31, 2014 08:08 by author Lisa Bonsall, MSN, RN, CRNP

I’m on my flight home after another successful LWW nursing conference! Nursing2014 Symposium was held from March 26 to March 29, and between the preconference workshops, sessions, exhibit hall, and city of Las Vegas, these days were overflowing with learning from national experts, networking with colleagues, and fun!

I was lucky enough to assist with the preconference workshop, Let’s Get Messy: Hands-On Anatomy, Resuscitation, and Emergency Skills Lab, presented by Scott DeBoer, RN, MSN, CEN, CPEN, CCRN, CFRN, EMP-P. During this one-of-a-kind course, we reviewed anatomy and practiced procedures such as intraosseous device placement, airway management techniques, and more. We even practiced skills on actual pig airways, hearts, and lungs. Here are some pictures!  

A recurring theme throughout the sessions I attended had to be changing clinical practice based on the evidence. In the opening session, Nurse’s Habits: “But That’s the Way We’ve Always Done It!, Julie Miller, RN, BSN, CCRN, reviewed many of the practices that we perform just because we’ve always done them. From the use of Trendelenburg for hypotension to methods used for verifying placement of feeding tubes, it is clear that we’ve got a long way to go to change practice based on the evidence. (FYI – unless contraindicated, position hypotensive patients flat with the legs elevated; get an x-ray to confirm feeding tube placement.) 

Here are some more tips & takeaways from this conference: 

*The guiding principles of patient and family-centered care are information sharing, participation, dignity and respect, and collaboration. 
Tiffany Christensen
Partnering with Patients – A Bed’s-Eye View of Patient and Family-Centered Care

*If you don’t know how to do something, don’t ask someone else who doesn’t know! 
JoAnne Phillips, MSN, RN, CCRN, CCNS, CPPS
Medication Safety: Going Far Beyond the Five Rights

*It costs between $45,000 and $55,000 to treat central line bloodstream infection (CLBSI). 
Sophia Chu Rodgers, ACNP, FNP, FAANP, FCCM
Best Practices for PICCs and CVCs

*The only thing you can pre-chart is a plan. Anything else, document as you do it or after it’s done. 
Edie Brous, RN, MS, BSN, MPH, Esq.
Documentation and Liability: How What You Write Can Show Up in Court

*HgbA1C levels are not accurate in sickle cell carriers or anemic patients. 
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
ADVANCED TRACK: Sweet Success – Making Sense of the Dizzying Deluge of Diabetes Drugs

*Test for alpha-1 antitrypsin deficiency in Caucasian patients younger than 45 with COPD. 
Mary Knudtson, DNSc, NP, FAAN
Acute Exacerbation of COPD

*Make sure the ‘tank is full’ before using vasopressors. 
Michael Ackerman, DNS, RN, ACNP-BC, FCCM, FNAP, FAANP
ADVANCED TRACK: Hemodynamic Stability

These are just the highlights of the many notes I took during the conference. I hope that those of you who attended had a great time learning and networking too! Don’t forget that you can access the slides from many of the presentations online at Lippincott's eConference Center. Also, be sure to complete your evaluations and obtain your CE credit!

I am now looking ahead and getting excited for the National Conference for Nurse Practitioners April 23-26, 2014 in Chicago, Illinois. What conferences have you attended or do you plan to attend this year?



Shampoo-rinse-repeat

clock March 14, 2014 04:55 by author Lisa Bonsall, MSN, RN, CRNP

I was a new graduate working in the Medical ICU, a few weeks off orientation, when I cared for Jenny*. She was 18 years old, the youngest patient on our unit. It was not the norm for such a young person to be a patient on our unit. In fact, it was odd. 

She was a college student who had gone to Student Health Services with an upper respiratory infection. She was given antibiotics and sent on her way. Why did she develop acute respiratory failure? I’m not sure anyone ever knew that answer. It was just one of those things…

Jenny spent a long time in our unit – months – battling the gamut of ICU complications we were used to seeing, just not in someone so young. ARDS, renal failure, GI bleed…just to name a few. She had her share of time spent on vasopressors, paralytics, and sedatives; endured arterial lines, SWAN placement, and dialysis; received multiple blood transfusions and courses of antibiotics; and was on and off isolation precautions for various resistant organisms. A tracheostomy and g-tube were placed when she became more stable and ready to wean from the ventilator. 

I was usually the nurse that wanted the sickest patients. I didn’t mind getting an unstable new admission or going on a road trip with a patient to a diagnostic study or procedure. One of my best days, however, was a slow one in the unit. Jenny was fairly stable, and she was my only patient that day. Her mom was there and was always eager to help with Jenny’s care. 

As the shift went on, and it looked like things were going to stay quiet on the unit (not that we EVER said that our loud), I asked Jenny if she’d like me to wash her hair. Her eyes got real big and she looked at me questioningly. She nodded.

Like many tasks, it took longer to gather supplies than to actually perform it. I finally found real shampoo (and conditioner!), used a water pitcher for wetting her hair and rinsing, set up a trash bag to catch the excess water, and piles and piles of towels. 

Jenny’s mom and I worked together washing her hair. We joked about opening our own salon and Jenny was smiling looking up at us. We made a mess and all got pretty wet, but it was worth it. We had gotten those weeks of knots and dried blood and betadine from her hair, combed it neatly, and it smelled so nice! 

When we finished, Jenny asked for a paper and pen. She wrote “Think you could shave my legs?”

Her mom and I looked at each other. “Sure.”

*Not her real name.



Take a look inside our collection of stroke resources

clock March 6, 2014 03:43 by author Lisa Bonsall, MSN, RN, CRNP

Caring for patients with stroke can be challenging; when a stroke is occurring, it is imperative to distinguish the symptoms from other diagnoses. Determining the type and location of stroke is yet another difficulty. Further challenges are met with treatment and rehabilitation. 

To help you manage these complex issues, we’ve created a Focus On: Stroke collection, which is comprised of journal content, as well as the following special features:

Each item in this collection is only $1.99, or you can purchase the entire collection together with the Powerpoint slides, podcasts, and the Take5 for only $19.99 (doesn’t include CE).  

To further your learning and help you meet your continuing education requirements, we've bundled the three CE articles below at a reduced rate. Earn 7 contact hours for only $19.99 – that's a savings of more than $50 if purchased individually!

Aneurysmal subarachnoid hemorrhage: Follow the guidelines
Nursing2013
3 contact hours

Ischemic Stroke: The first 24 hours
The Nurse Practitioner
2 contact hours

Recognizing and Preventing Acute Stroke in Women
Nursing2012
2 contact hours

I hope you’ll take some time to explore this collection! Have a question or comment? Please feel free to connect with me here on the blog by leaving a comment or you can email me at clinicaleditor@nursingcenter.com.  



Recent Comments

Comment RSS

About your comments

We welcome comments, discussion, curiosity, and debate. Let us know about your nursing lives and personal experiences. We reserve the right to moderate comments that are intended to sell something or that are inappropriate or hostile.

Disclaimer

Views expressed on this blog are solely those of the authors or persons quoted. They do not necessarily reflect Lippincott's NursingCenter.com's views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.

Sign in