Clinical Rounds

March 2011 
Volume 41  Number 3
Pages 19 - 21
  PDF Version Available!

In Gallup's annual Honesty and Ethics poll, nurses once again outranked all other professions surveyed. Eighty-one percent of survey respondents rated nurses "very high or high." The next-highest ranked professions are as follows: * military officers, 73% * druggists or pharmacists, 71% * grade school teachers, 67% * medical doctors, 66%.At the bottom of the heap? members of Congress (9%), car salespeople (7%), and lobbyists (7%).For more details, visit and search for honesty and ethics poll.In a study, patients with depression plus poorly controlled diabetes or coronary heart disease improved significantly when provided with guideline-based care from nurses. Participants (214 patients) were randomly assigned to a usual care group or the intervention group. Working with each patient's primary healthcare provider, nurses provided patients in the intervention group with guideline-based collaborative care management. The primary goal was to control risk factors associated with multiple diseases.Compared with patients who received usual care, those in the intervention group experienced greater improvement in glycated hemoglobin levels, low-density lipoprotein cholesterol levels, systolic BP, and depression scores after 12 months. These patients were also more likely to have had at least one adjustment in insulin, antihypertensive medication, or antidepressants in the study period and experienced a better quality of life.The researchers concluded that "an intervention involving nurses who provided guideline-based, patient-centered management of depression and chronic disease significantly improved control of medical disease and depression."Source: Katon WJ, Lin EH, Von Korff M, et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med. 2010;363(27):2611-2620.No standard guidelines have been developed to help clinicians decide whether a patient presenting to the ED with signs and symptoms of a food allergy should be

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