ASHPE Awards 2017: Wolters Kluwer wins big!

 
ashpe-award_2017.bmpWolters Kluwer continues to shine in the American Society of Healthcare Publication Editors (ASHPE) awards! In 2016, Wolters Kluwer won 24 times, and this year, we exceeded that amount and won 27 awards across 20 categories.

We are particularly excited to announce that Lippincott NursingCenter.com won three awards this year. NursingCenter is a proud part of Wolters Kluwer’s Lippincott journal portfolio. The award-winning nursing journals from Wolters Kluwer are listed below. For the full list of award-winners, please visit ASHPE’s website.

GOLD SILVER BRONZE
 
Posted: 5/17/2017 1:35:22 PM by Cara Deming | with 0 comments

Categories: Inspiration


If only I had said something…

empty-bench.pngI walk into the room and look at the figure of a 20-year-old college student lying in the bed after a deliberate overdose, intubated and on a ventilator, the steady rhythm of the machine making her chest rise and fall and the steady beeping of the heart monitor somewhat reassuring that my patient was still alive. The parents sitting by her bedside with tears streaming down their faces. The mother speaks to me, “If only I had said something. I thought it was only stress of being in college and having to take final exams; if only I had said something…”.

If only I had said something…these are words none of us wants to say or hear, but too often this is exactly what happens. Frankly, I’ve heard those words too many times in my professional practice. How many times have you wondered if someone you know has a mental health disorder? Maybe, you wonder if you have a disorder? When we look at the statistics, the impact of mental health issues —which is defined as any mental, behavioral, or emotional disorder, excluding developmental and substance use disorders — is sobering. Mental health issues affect 21.2% of adult females and 24.3% of adult males, per the National Institute of Mental Health (NIMH, 2016).  None of us are immune to being touched by someone who has a mental health disorder. From generalized anxiety disorder, panic disorder, post-traumatic stress disorder, bipolar disorder, major depressive disorder, and so on, we have all known someone or taken care of someone who has a mental health issue. Perhaps the greatest issue we face is being able to recognize when someone needs professional help or when we need professional help.

Although we, as health care professionals, recognize that managing mental health disorders is as important as managing any other disorder, the stigma in the community that mental health issues are a sign of weakness or that the person can snap out of it, still exist. We must take an active role in educating the community on when a person may have a mental health issue and not just feeling anxious or feeling down about something that happened in their life. People who entertain risky behaviors, such as prescription drug misuse, exercise extremes, compulsive buying, and risky sex may have an underlying mental illness (http://mentalhealthamerica.net).

The theme of Nurses Week is Nursing: The Balance of Mind, Body, and Spirit and mental health is certainly a part of that initiative. May is also Mental Health Month. The National Institute of Mental Health (NIMH) is leading the initiative on mental health awareness and management by outlining objectives to define mechanisms of complex behaviors, recognizing those who have mental health issues, and when intervention is necessary, and striving for mental health illness prevention.

As nurses, we must speak up when we suspect someone may have a mental health issue and encourage that person to seek professional help.  We must have the courage to speak up even if that person is our colleague, in our family, or even ourselves.  No more should we hear, “If I had only said something…”.
 
Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN
Chief Nurse
Health Learning, Research & Practice
Wolters Kluwer


 
Posted: 5/12/2017 8:06:27 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration


Are You Soaring Spiritually?

bird-soaring.jpgSpirituality is a vague concept for many nurses—especially when our primary focus is implementing physical, scientific interventions. As holistic caregivers, we believe nursing care should be for body, mind, and spirit. Our personal spirituality, however, is easy to ignore. Some of us don’t think about our spirituality until we are turned upside down by a life crisis. But over time, even without crisis, if we don’t care for our spirits we will suffer consequences.
 
Paying attention to personal spirituality is especially important for nurses. Researchers and spiritual care experts have found that offering good spiritual care requires the nurse to attend to his or her own spirituality (makes sense, right?) (Baldacchino, 2011; Taylor, 2009; 2011). Furthermore, we regularly experience spiritual distress in our work, which leads to weariness, depression, compassion fatigue, and burnout. Moreover, being spiritually healthy – soaring spiritually – feels better than spiritual malnourishment. In fact, it feels great!
 
What is spiritual health? Our spirit is the core of our being, a characteristic of all humanity. While our spirit is accessed through our mind, spiritual health is more than mental health. Spirituality involves the ultimate search for meaning and understanding of the sacred or transcendent. It expresses a universal human capacity to transcend ourselves and connect with God, other people, and the world around us. It is through spirituality that we find self-fulfillment, peace, and meaning in life and suffering (Lepherd, 2015). A frequently used assessment of spiritual health is the Spiritual Well-Being Scale (SWBS), a general indicator of perceived well-being and spiritual quality of life, with subscales that assess Religious Well-Being (one's relationship with God or “higher power”), and Existential Well-Being (one's sense of life purpose and life satisfaction) (Bufford, Paloutzian, & Ellison, 1991).
 
What helps nurses’ spirituality? Recently, researchers in Iran found a positive correlation between nurses’ clinical competence and spiritual health, and professional ethics and spiritual health (Tabriz, Orooji, Bikverdi, & Taghiabad, 2017). A U.S. chaplaincy department conducted a randomized controlled study of a spiritual retreat for nurses. Nurses who did the spiritual retreat scored higher at 1 and 6 months on the SWBS and Daily Spiritual Experience Scale than nurses with no retreat (Bay, Ivy, & Terry, 2010). The ancient text of Proverbs in the Tanach (Hebrew Bible) and Christian Holy Bible speak about what makes for spiritual health (kind words, trustworthy words, humility, relationship with God, clean heart), versus a crushed, broken, or weighed down spirit (i.e., Psalm 51; Proverbs 15:4, 16:19-24, 17:22, 18:14, 29:23). Wise king Solomon wrote, “Keep your heart, for from it flow the springs of life” (Proverbs 4:23, ESV).
 
How are you caring for your spirit? Do you engage in spiritual renewal? A renewal experience is doing something you enjoy like a walk in nature or a hobby. I find renewal exercising with friends and playing the piano. For nurses of faith, attending a gathering in your worship tradition can be (should be!) a renewal experience.
 
Meet regularly with friends who will listen to and support you. Two months ago, I reluctantly joined a small group from my church to share time, meals, and service projects. I expected this to be work. To my surprise, even though I can’t attend regularly, the group is renewing me. This week, a young man shared his struggles with me, and I shared mine. He texted me today saying he was praying for me, and that “your absence is felt and we cherish when you are able to attend.” I felt spiritually connected, that someone of like mind cares for me. That is spiritual renewal in the struggle of life.
 
Below are ideas for spiritual self-care. As we think about balancing body, mind, and spirit during this year’s 2017 National Nurses Week, take time to care for your spirit.
 

Ideas to Help Your Spirit Soar

  1. Daily quiet time with personal reflection or meditation on spiritual readings.
  2. Read enlightening materials—spiritual readings (i.e., Bible) or devotional books.
  3. Plan for times of rest and take your mind off work, off problems, and relax (Sabbath). Consider a one-day or longer “guided spiritual retreat” at a retreat center near you.
  4. Attend gatherings of your faith tradition.
  5. Spend time in prayer, talking with the Mystery many call God.
  6. Join a “share group” of people with whom you have a common interest.
  7. Do special things you enjoygo to a greenhouse, art gallery, antique mall, camping or on a picnic, take in a movie with a friend. Be creative!
  8. Engage in regular physical exercise (walk/run alone or with a friend; join an exercise group).
  9. Conduct a spiritual self-assessment; heighten awareness of your spirituality (Beckman, Boxley-Harges, Bruick-Sorge, & Salmon, 2007).
  10. Engage in spiritual direction with a spiritual director or companion consistent with your beliefs (http://www.sdiworld.org).

References:
Baldacchino, D. R. (2011). Teaching on spiritual care: The perceived impact on qualified nurses. Nurse Education in Practice, 11(1), 47–53. doi: 10.1016/j.nepr.2010.06.008
Bay, P. S., Ivy, S. S., & Terry, C. L. (2010). The effect of spiritual retreat on nurses’ spirituality: A randomized controlled study. Holistic Nursing Practice, 24(3), 125-133.
Beckman, S., Boxley-Harges, S., Bruick-Sorge, C., & Salmon, B. (2007). Five strategies that heighten nurses’ awareness of spirituality to impact client care. Holistic Nursing Practice, 21(3), 135-139.
Bufford, R. K., Paloutzian, R. F., & Ellison, C. W. (1991). Norms for the Spiritual Well-Being Scale. Journal of Psychology and Theology, 19(1), 56-70.
Lepherd, L. (2015). Spirituality: Everyone has it, but what is it? International Journal of Nursing Practice, 21(5), 566–574. doi: 10.1111/ijn.12285
Tabriz, E. R.., Orooji, A. Bikverdi, M. & Taghiabadl, B. A. (2017). Investigation of clinical competence and its relationship with professional ethics and spiritual health in nurses.   Health, Spirituality and Medical Ethics, 4(1), 2-9.
Taylor, E. J. (2009). What do I say? Talking with patients about spirituality. West Conshohocken, PA: Templeton.
Taylor, E. J. (2011). Spiritual care: Evangelism at the bedside? Journal of Christian Nursing, 28(4), 194-202. doi: 10.1097/CNJ.0b013e31822b494d
 
Kathy Schoonover-Shoffner, PhD, RN
National Director, Nurses Christian Fellowship USA
Editor-in-Chief, Journal of Christian Nursing
 
Posted: 5/11/2017 7:56:52 AM by Lisa Bonsall, MSN, RN, CRNP | with 2 comments

Categories: Inspiration


Protect yourself so you can continue to protect others

How often have you given your patients advice on preventive health care and screenings and heard that nagging, guilty little voice in your head saying, “Don’t be a hypocrite, don’t forget about you”? Part of our job as nurses is to teach our patients about preventive health care and recommended screenings to maximize their health, longevity, and quality of life. While we know the importance of these health care services, however, we don’t always translate that into practice for ourselves.

Nurses may not follow recommended preventive and screening practices for a multitude of reasons. Shift work, long hours, limited paid time off, and an unpredictable schedule make it difficult to schedule appointments. As caregivers to the core, the needs and activities of our children, spouses, and parents become our focus during our non-working hours, and our own health care needs tend to take a backseat. But, in order to take care of our patients, as well as our families, we must make our own health a priority. A sick nurse can’t take care of anyone.

schedule.pngSo, what exactly do you need to do? To start with, schedule a check-up with your practitioner. Your practitioner will perform a physical examination, provide counseling, and perform or order screening tests and preventive services based on your age, gender, and risk factors. Your practitioner may include the following during your check-up, based on the recommendations by the U.S. Preventive Task Force:
  • Screen for alcohol misuse, intimate partner violence, depression, or high blood pressure
  • Order a serum blood test to screen for human immunodeficiency virus or hepatitis C virus
  • Order a serum lipid blood test to screen for hyperlipidemia
  • Order a dual-energy X-ray absorptiometry scan to screen for osteoporosis
  • Order or perform cancer screenings at the appropriate intervals, including breast cancer, cervical cancer, and colorectal cancer screenings
  • Order or perform any additional targeted screenings based on your history, the presence of risk factors, and physical examination findings
In addition to the health care screenings, preventive measures can stop certain diseases from occurring in the first place. The Centers for Disease Control and Prevention recommends the following vaccines for all health care workers: vaccine.png
  • Hepatitis B series
  • Influenza (annually)
  • Measles, Mumps, & Rubella
  • Varicella
  • Tetanus, Diphtheria, & Pertussis
  • Meningococcal

Some of these vaccines may be required at your facility, so they may be given free-of-charge during work hours, which saves you the time and inconvenience of scheduling a separate appointment. If they’re not, ask your practitioner about them at your check-up. It’s important to protect yourself so you can continue to care for others.

Nurses Week is the perfect time to renew our commitment to take better care of ourselves by practicing preventative care measures and making those screening appointments. Be well!

References:
 
Vicki Cantor, RN, BSN, MA
Clinical Editor
Health Learning, Research & Practice
Wolters Kluwer

 
Posted: 5/10/2017 7:17:08 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration


Stress: The Elephant in Your Career

stress.png“I resigned my staff nurse position today,” my young colleague confessed, “after only 7 months. I loved taking care of patients and families, but just couldn’t take it anymore – the other nurses complaining, but never speaking out, the rude behavior and put downs, and the nurse manager who made bad decisions and supported the wrong people – will it be like this in my next job? I feel like such a failure.” I have heard this story at least three times over the past year and I am only an N of 1. Recent studies have documented the alarming percentage of nurses who are leaving their jobs or leaving the profession climbing to 17.2 % in 2016 and costing hospitals an average of $5.2M – $8.1M annually. 1 Reasons cited by nurses for leaving include poor management, and stressful work conditions, including inadequate staffing, verbal abuse, and work-life balance issues. 2, 3 While employing organizations are deciding how to tackle this problem, you need stress relief now to get you through the day. First, let’s revisit the concept stress, then consider a few simple and creative strategies that you can use to get the elephant out of your workday ---- STRESS!


Stress Revisited

Hans Selye, a Canadian physician, conceptualized the “stress response” and conducted research on how it worked after observing patients’ responses to the stress of hospitalization. 4 “Stressors” are those factors experienced or perceived by individuals as causing harm or distress. “Experienced” or “perceived” is an important distinction since the stressor can be real and direct like a contracting a virus or being robbed at gunpoint or the stressor could be the result of how we view a situation; a putdown for one nurse can be devastating and for another a minor blip in the course of a day’s work.  The apathy of her colleagues, rude behavior, put downs, and the passivity of the nurse manager were my colleague’s perceived “stressors.” Stress, on the other hand, is the individual’s reaction or the body’s response to real and perceived threats whether that reaction is manifested physically or mentally. In this case, my young colleague’s reaction was to let the stressors overwhelm her to the point of leaving – remember fight or flight? She could have tried to “change her perceptions,”  “change her reactions,” “change her behavior or get help,” instead the stress led to resignation.  Depending on the severity of the stress, individuals and organizations always have a measure of control in managing “stressors.”  Instead of merely reacting, striving to develop a deep awareness of how you can plan, craft, and control your responses to difficult situations can be the first step to stress inoculation. 
 

Stress Inoculation

                You get to choose how to “vaccinate” your stress. Choose “ingredients” based on your preferences, style, and time – some take no time, others take a commitment of 20 minutes to half an hour per day. Try one strategy per week to find what is right for you. Continue with those you believe are helping you to respond effectively instead of reacting haphazardly and then move on to more structured and serious stress management modalities. Below is a simple formula to begin stress reduction. It’s your choice!   
  • walking_biking.pngMove -- Twenty minutes a day of running, walking, cycling, etc., will help to dissipate the effects of stress. Regular exercise improves cardiovascular function, produces endorphins in the brain that result in improved mood, strengthens muscles, and improves tone.  If you are not inclined to run, sign up for yoga or Pilates.  These meditative exercise forms stretch and tone your body and improve your posture and flexibility which can become a metaphor for how you respond in stressful situations. Regularly moving the body increases body awareness during stressful interactions.  So, if you experience bullying or other negative interpersonal encounters on the job, use your body’s signals to respond – stand taller, face your nemesis or – if you are too rattled – leave the scene, it is your absolute right to remove yourself from such situations.  Better yet, dance!
  • Rehearse difficult conversations in the privacy of your car – you could even let loose, scream, use profanity – no one will hear you but you, and hearing how you respond or “talk back” can be helpful in changing your verbal responses during stressful situations. Just be cautious; if someone in the next car notices your solitary conversations, just smile, fiddle with the radio and pretend you’re singing. Rehearsals should help your responses become more rational, more focused, less defensive and more “I” oriented. Read up on developing calm, assertive responses or join an assertiveness training group. In time you will be surprised when the assertive responses that you rehearsed become natural and automatic during difficult situations.
  • Laugh – Humor provides release and helps put things in perspective.  Most importantly, laugh at yourself even at your best efforts.  At the urging of my internist, I hired a personal trainer and worked out 2 days a week for 2 years – the result, I spent $3,000 dollars and lost three pounds but I was “toned.” I am still laughing at the result. Get a small group of like-minded nurse colleagues together and watch funny SNL’s vignettes or YouTube videos. My SNL favorites are from the 1980’s particularly Jane Curtin attending assertiveness training class or Roseann Roseanna Danna reporting the news.  Humor heals and humor shared is even more healing.
  • Reframe difficult situations, that is, change the meaning, the emotional tone, or your viewpoint of a difficult situation and place it in another frame.  Remember when Huckleberry Finn, a Mark Twain 5 character,  had to whitewash the fence – it was work he did not want to do but he “reframed” and pretended to be having such great fun that all his friends begged to help and he finished in record time. How would you reframe a heavier than usual patient assignment or having to work on a holiday?  It is possible to change what we think or how we view any situation.  Conjure up at least 3 positive or at least, neutral interpretations of the next difficulty you encounter.  Flexing perspective is liberating.
  • Imagine – Your imagination can save you from revealing negativity, disapproval or even fear.  Use fantasy to get yourself through difficult situations. For example, when attending that meeting you dread with all of those difficult colleagues gathered in one place, imagine that you are all different animals in a zoo. Imagine the sounds they would make when things got tough or how they might gallop or slither from the room. You will get a pleasant look on your face when you are fantasizing and group members will think that you are relaxed and have it together.  The rule is to keep your fantasy private.
  • Sing in the privacy of your car or the shower. Sing uplifting and inspirational songs that emphasize self-empowerment. Or download the following songs on your phone and sing along or listen on your break. Music reorganizes the brain and the messages sung are uniquely remembered. Here is a selection of empowering songs to get your started. If you are of my vintage, Sinatra’s, “I Did It My Way,” or “I Gotta Be Me,” or a few pop favorites, “Let it Go,” or “Brave,” or “Fight Song.”  It you are hip, there is Des’ree’s “You Gotta Be,” and if you are inclined to country music, one of my favorites is Bobby Bare’s, “Drop Kick Me Jesus thru the Goalpost of Life.” In Bobby’s words, “If you have the will, God has the toe.” Make your own song selections and share.
So there is it, a simple formula that will get your started to managing every day stress:
 
Move + Rehearse + Laugh + Reframe + Imagine + Sing
 
If your health is at risk or your situation is dire, consult a health professional.  Take care of yourself!
 
References:
  1.  2016 National Healthcare Retention & RN Staffing Report Published by: NSI Nursing Solutions, Inc. www.nsinursingsolutions.com.  Accessed 4/30/2017
  2. Flinkman M, Ulpukka I, Salantera  S, International Scholarly Research Notices. August 20, 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762080/  Accessed 4/30/2017.
  3. Robert Wood Johnson Foundation. The RN Work Project, September 1, 2009. http://www.rwjf.org/en/library/research/2009/09/the-rn-work-project.html.  Accessed 4/30/2017
  4. Selye H. The Stress of Life. New York: Mc Graw Hill, 1956.
  5. Twain, M. Adventures of Huckleberry Finn. Costa Mesa, California: Saddleback Educational Publishing, 1999,2011

Gloria F. Donnelly, Ph.D., RN, FAAN, FCPP
Professor and Dean Emerita
College of Nursing and Health Professions
Drexel University

Editor in Chief, Holistic Nursing Practice

 
Posted: 5/9/2017 6:46:20 AM by Lisa Bonsall, MSN, RN, CRNP | with 3 comments

Categories: Inspiration


Hit the road…or the mat

It’s no secret that as caregivers we’re typically not very good about taking care of ourselves. We get home after a long day, evening, or night at work, and then it’s time to shift gears and settle into our second job, taking care of things at home. By the time we actually have time for ourselves, we’re exhausted.

We know the benefits of getting at least 2 hours and 30 minutes of moderate-intensity aerobic activity a week. It helps:
  • control your weight
  • reduce the risk of type 2 diabetes and metabolic syndrome
  • reduce the risk myocardial infarction and stroke
  • reduce the risk of breast and colon cancer
  • strengthen bone and muscle
  • improve mental health and mood
  • increase longevity.
But, just how do you fit exercise into an already busy, exhausting schedule? My brother, an exercise physiologist says, that there are plenty of 15-minute opportunities in a day; 96 to be exact, so there’s no reason why you can’t be intentional about reserving at least one or two of them for yourself. It seems pretty achievable when you look at it that way, doesn’t it?

Well it is achievable, and you don’t need an expensive gym membership to do it. Start by taking a 15-minute walk around your neighborhood. Ask a friend or family member to join you, or take the family dog for a walk. It’s a great way to relieve stress, reconnect with others, and get exercise at the same time. On your day off, increase the length of your walk by walking through a local park, around town, or along the beach. You’ll log in exercise time and gain some peace of mind.

yoga.jpgTo increase strength, endurance, and body tone, take another 15 minutes to practice yoga. You don’t need to venture away from home to establish a regular practice. All you need is a yoga mat and some floor space to get started. There are online videos and apps to guide you through your practice.

Yoga practice consists of different postures, referred to as asanas. During a practice session, you’ll use your breath to help guide you through the different postures, and you’ll focus on using core strength (referred to as mula bandha) to move energy through your body.

Before you get started, you’ll want to familiarize yourself with the different schools of yoga, so that you can choose the one that’s right for you. Some of the schools include:
  • Asthtanga, a fast-paced practice, consists of a sequence of postures that provide a vigorous workout.
  • Bikram, commonly referred to as “hot” yoga, consists of 26 consecutive postures that are performed in a room heated to about 100° F.
  • Iyengar, a slow-paced practice, focuses on stillness and form with each posture.
  • Jivamukti, a fast-paced practice similar to Asthtanga, incorporates meditation, chanting, and readings along with the postures.
  • Kripalu, or gentle yoga, consists of postures designed to tone muscles, improve blood flow, and energize the mind.
  • Kundalini, utilizes rapid breathing, chanting, and meditation to move through slow, deliberate movements.
I’ve been a walker for quite some time, but I only attended my first yoga session about two years ago. My daughter asked me to attend a “hot” yoga session that a friend was teaching. I had no idea what “hot” yoga was, but I thought why not support her friend and give it a try. I thought I’d be calmly sitting on a mat breathing and relaxing. Little did I know that I’d be working up a sweat trying to keep up with the instructor as she led us rapidly through a variety of postures.

I enjoyed the session but it wasn’t until my daughter gave me a gift certificate for a private yoga lesson that I became hooked. Now I’m a regular weekend attender at a local yoga studio where I practice Asthtanga yoga. During the week, I practice at home using an app. Since beginning yoga four months ago, I’ve been able to curb my anxiety, sleep at night, gain flexibility, and increase my core strength.

The beauty of both of these exercise options is that you can do them anytime and anywhere…wherever and whenever you can find those 15 minutes, 15 minutes where you can refocus and simply take care of you.

Collette Bishop Hendler, RN, MS, CIC, CCRN (Alumnus status)
Senior Clinical Editor
Health Learning, Research & Practice
Wolters Kluwer



 
Posted: 5/8/2017 7:14:45 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration


Healthy Eating: Food for Thought

FDA_Nutrition_Facts_Label_2006.pngWhat information do you consider when you read a food label? My bet is that for those who do take the time to read the fine print, it’s typically the calorie count, the fat and sodium content, and perhaps even the recommended daily allowance of vitamins and nutrients that take center stage, especially for people who have an eye toward losing weight or making healthier choices. But what about the ingredient list? The ingredients in particular, including the ones with names that sound like compounds best discussed in a chemistry class, are often ignored. And I’m sure we all know people who don’t give any part of nutrition labels even a passing glance. I’ve actually heard friends admit, “I don’t want to know what’s in my food; I just want to enjoy it.” There’s no doubt there’s a very strong emotional connection to foods that we love…but we owe it to ourselves to take a much closer look at exactly what we put into our bodies.
 
It’s well established that our food choices play a significant role in our overall health and our risk of developing or worsening chronic diseases. Much has changed in relation to the science of healthy eating and disease prevention since many of us studied nutrition in nursing school. Have you kept up with the latest evidence to inform your own food choices or those of your family and patients, or do you place your trust in popular media and advertising claims about diet and nutrition? How do you knowingly separate the healthy food facts from the hype? Unfortunately, the hype comes from advertising dollars that, in a large part, serve to drown out the evidence from legitimate food science research.
 
I’ve always tried to eat “healthy,” but in retrospect, my diet left a lot to be desired. There’s nothing like a health scare to motivate new learning. My sentinel moment occurred the day I discovered that I had developed a major food allergy to carrageenan. To my great surprise, consuming my favorite brands of coffee creamer, yogurt, ice cream, and sorbet started to reliably induce progressively worsening wheezing, facial flushing, and tachycardia. The reaction that captured my full attention came very close to sending me to the emergency department for treatment. Being a stubborn ED nurse, I self-treated with over-the-counter antihistamines and fully committed to figure out exactly what caused me to react. Through the process of elimination, I found that the common denominator in all four foods was carrageenan. Eating even a small amount of it reproduced my symptoms quite predictably. Switching to brands of products that didn't contain the offending ingredient and carefully scrutinizing all food labels made eating much less eventful and far more enjoyable.  
 
When I researched carrageenan, I learned that it’s made from red seaweed and is added to food as a non-nutritive thickening agent. Although it's a natural product found in many "healthy" foods, it’s a potent inflammatory mediator that’s been linked to inflammatory bowel disease and colon cancer.1 Carrageenan is actually used as an inflammatory agent to test the efficacy of anti-inflammatory drugs.1 Knowing the risk it creates, even for people who don’t have an allergy to carrageenan, I had to wonder why it’s even placed in the products we buy and why it’s so pervasive? 
 
Sadly, I learned that there are many other chemical additives commonly found in our food supply that are suspects in causing a myriad of human health issues. Take artificial sweeteners, for example: a prospective study just published from the Framingham Heart Study Offspring Cohort group revealed that individuals with the highest consumption of artificial sweeteners had a statistically significant higher risk of stroke and dementia, even after other possible contributing factors were adjusted.2

So, my personal mission began to learn as much as possible from legitimate, high quality, evidence-based health literature about nutrition and food safety. The information I found inspired me to make a personal commitment to eat “clean”— that is to avoid food with chemical additives — and completely change my diet to consume foods derived primarily from whole, plant-based sources. The fewer the ingredients, the better. I’ve learned that plant-based, nutrient-dense foods are the very best to fuel our bodies and prevent disease.  Yes, these foods can be prepared in very delicious and healthy ways. Eating like this feels different because most of us were not raised on a clean, plant-based diet. We were raised on high sugar diets with artificial colors, preservatives, and chemical additives because that’s what was advertised on television and we came to believe that these “foods” were somehow good for us.
 
Changing the way we eat is a very heavy lift. It clashes with the typical societal food norms, family customs, and available choices on many restaurant menus. It’s especially tough to be discriminating with food choices when eating out. Few people really understand how to feed someone on a plant-based diet. For example, I was served only a plate of plain lettuce at one recent function that I attended by those who knew my plant-based preferences. Keep in mind that all manner of fruits, vegetables, seeds, nuts, legumes, grains, and healthy, plant-based oils are part of the repertoire of possibilities. 

vegetables.pngEating a clean, plant-based diet is a journey. I’ve found that the more I learn, the easier it is to make good choices. A very broad base of scientific evidence exists to support that dietary choices are firmly connected to personal health. As nurses, we need to expand our knowledge base on this subject and incorporate teaching about the impact of food choices on health into our teaching with patients. Simple steps like choosing to bring fruits, vegetables, nuts, and healthy grains into work for snacks in the break room can make a positive difference (as opposed to the usual tempting fare found on most nursing units). For those of you interested in learning more, I’ve included a reading list of resources that were most helpful to me in shaping my own perspectives. One of my favorite websites, https://nutritionfacts.org, provides reviews on the latest high quality, peer reviewed, evidence-based research on food, nutrition, and overall health. The information contained on this website has enabled me to better make healthy lifestyle decisions. 
 
As we celebrate Nurses’ Week and beyond, I encourage you to take stock of your own dietary habits and make informed choices that promote optimal health!
 
Bon appetit!
Linda
 
References:
1.  Borthakur A, Bhattacharyya S, Anbazhagan AN, Kumar A, Dudeja PK, Tobacman JK.
Prolongation of carrageenan-induced inflammation in human colonic epithelial cells by activation of an NFκB-BCL10 loop. Biochem Biophys Acta, 2012;1822:1300-1307. Retrieved at:  http://ac.els-cdn.com/S0925443912001032/1-s2.0-S0925443912001032-main.pdf?_tid=0b956676-2db2-11e7-8d56-00000aacb360&acdnat=1493563018_03f88014c2f300c3ba560bb71255bd30.

2.  Pase MP, Himali JJ, Beiser AS, Aparicio HJ, Satizabal CL, Vasan RS, Seshadri S, Jacques PF.  Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia:  A Prospective Cohort Study. Stroke. 2017;48:1139-1146.  Retrieved April 24, 2017: https://doi.org/10.1161/STROKEAHA.116.016027.
 
Suggested Reading List
  • Campbell, T. C., & Campbell, T. M.  (2006). The China Study:  The Most Comprehensive Study of Nutrition Ever Conducted.  Dallas:  Benbella Books.
  • Fuhrman, J.  (2011). Eat to Live.  New York:  Little, Brown and Company.
  • Greger, M., Stone, G. (2015). How Not to Die.  New York: Flatiron Books.
  • Greger, M. https://nutritionfacts.org  Accessed April 30, 2017.
  • Robinson, J. (2013).  Eating on the Wild Side.  New York:  Little, Brown and Company.
 
 Linda Laskowski-Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN
Editor-in-Chief, Nursing2017
Vice President: Emergency & Trauma Services
Christiana Care Health System – Wilmington, Delaware


 
 
Posted: 5/7/2017 11:25:39 AM by Lisa Bonsall, MSN, RN, CRNP | with 4 comments

Categories: Inspiration


Work-Life Balance: The Elusive Golden Ring

year-of-healthy-nurse-badge.jpgIn anticipation of Nurses Week, on May 1st the ANA launched its “Healthy Nurse, Healthy Nation Grand Challenge” initiative, designed “to help nurses improve their overall health and challenge the rest of the country to do the same.” It’s a worthwhile effort – lord knows we can all use healthier habits in our lives.

As nurses, we work long hours. It can be on our feet doing direct care, attending meetings and writing budgets and working on staffing issues, traveling on public transportation or dealing with traffic to visit patients at home, or teaching the next generation of nurses. In my case, it’s spending hours on a computer, conference calls, and frequent travel to meetings. Then, after work, we go home and take care of others and other things – household bills and repairs, managing growing families, or going to school or even to other jobs, exercising, (notice I put exercise last…) – and then fall into bed wired and exhausted. In the morning, there’s coffee or diet cola to get us up and running and we do it all over again.

question.pngAsk yourself:
  • When was the last time you went outside just to experience the sun on your face or take a leisurely walk?
  • When was the last time you did something just for yourself?
  • When was the last time you did something fun with your kids during the week?
  • When was the last time you can say that you had a good night’s sleep and woke up feeling rested?
We have the data that show that we need to pay attention to how we take care of ourselves.  Research published in AJN on health promotion practices of nurses noted that 66% of the nurses reported too many competing priorities; these nurses scored lower on spiritual growth, interpersonal relationships, and stress management.  We also know that most of us are chronically sleep-deprived -- in another article in AJN, The Potential Effects of Sleep Loss on a Nurse’s Health, the author cites studies that reveal that daily sleep time for nurses was less than six hours, and that many nurses work 15 hours or more a day, or more than 60 hours a week. And we know that fatigue translates into a higher risk for making errors.

Work-life balance is an elusive goal, at least it is for me and many people I know. It’s run, run, run most of the week; catch-up on things we didn’t get to on the weekends and squeeze in time for family and friends. We are often our own last priority when it comes to healthy practices. A health scare a few years ago caused me to rethink how I work, and while I still don’t have ideal work-life balance, I’m doing a few things that are simple and easy to work into a schedule.

Here they are in case they are helpful to you: peanut-butter-toast.png
  • Always eat some kind of breakfast, preferably protein and low carb (you’ll avoid that mid-morning slump. My go-tos: hard-boiled egg, peanut butter on a piece of whole wheat bread, a scoop of cottage cheese with some fruit).
  • Walk around the block (or two) at lunch time or, if too busy, before you head home.
  • Park further away than you have to – walking even a little is better than none. Take the dog (or invite your partner or a child) for an evening walk
  • If feeling very stressed, remove yourself (even if only to the bathroom) and take a few minutes to take a few deep breaths, get a drink of water, and clear your head.
  • Listen to music on the way home from work. I find it helps me make that transition and I arrive home more relaxed.
  • Don’t check email or social media or use a computer or tablet before bed (I know – it’s hard). Give yourself at least an hour to wind down before sleep.
  • Try to get 7 hours of sleep each night.
We make appointments and commitments with other people and consider ourselves dependable and responsible when we keep them. We need to feel the same about taking time for ourselves. Make an appointment with yourself to walk, work out, read, see a movie – anything that will give you time for yourself – put it on the calendar, and honor that commitment just as you would others. You owe it to yourself.

Shawn Kennedy, MA, RN, FAAN
Editor-in-Chief, American Journal of Nursing

 
Posted: 5/6/2017 6:59:51 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration


Balancing Mind, Body, and Spirit: Blog Series for Nurses Week 2017

NNW-logo-300-px.jpgHappy National Nurses Week! As we approach this year’s celebration, I’d like to introduce our upcoming blog series related to the theme of balancing mind, body, and spirit. Several nurse experts will share their knowledge and advice around different aspects of self-care for nurses.
I think you’ll enjoy theses daily blog posts, starting
May 6th, 2017. We welcome any and all feedback or personal experiences that you’d like to share!

Work-Life Balance: The Elusive Golden Ring
Shawn Kennedy, MA, RN, FAAN
Editor-in-Chief, American Journal of Nursing
 
Healthy Eating:  Food for Thought
Linda Laskowski-Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN
Editor-in-Chief, Nursing2017
Vice President: Emergency & Trauma Services
Christiana Care Health System – Wilmington, Delaware
 
Hit the road…or the mat
Collette Bishop Hendler, RN, MS, CIC, CCRN (Alumnus status)
Senior Clinical Editor
Health Learning, Research & Practice
Wolters Kluwer
 
Stress:  The Elephant in Your Career
Gloria F. Donnelly, Ph.D., RN, FAAN, FCPP
Professor and Dean Emerita
College of Nursing and Health Professions
Drexel University
Editor in Chief, Holistic Nursing Practice
 
Protect yourself so you can continue to protect others
Vicki Cantor, RN, BSN, MA
Clinical Editor
Health Learning, Research & Practice
Wolters Kluwer
 
Are You Soaring Spiritually?
Kathy Schoonover-Shoffner, PhD, RN
National Director, Nurses Christian Fellowship/USA
Editor-in-Chief, Journal of Christian Nursing
 
If only I had said something…
Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN
Chief Nurse
Health Learning, Research & Practice
 
Be sure to check out all of our Nurses Week plans and take advantage of CE collections, free articles, a crossword puzzle, and more!

Also, follow us on social media -- We’ve got some special giveaways that you don’t want to miss!
 
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Have a great week, everyone!

 
Posted: 5/4/2017 8:13:42 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration


My Nursing Care Plan: One Year Later

My-Nursing-Care-Plan.PNGIt’s hard to believe that it’s been a year since we began developing My Nursing Care Plan! It has been such a fun project for me, as well as a learning experience. Thinking about and organizing the content was challenging, even though, as a nurse myself, I know what my requirements are, what I need to do to stay up-to-date in nursing, and what I should be doing to balance work and life! The difficulty was putting it down in words and figuring out how to try and juggle it all. Creating the companion video and infographics was something new for me too – but I do love learning new things, especially when it comes to technology – so it was quite a treat to be involved in those projects. Lastly, having a conversation with Michelle Berreth RN, CRNI®, CPP, a nurse educator for the Infusion Nurses Society (INS), was quite eye-opening and inspiring, but more on that later…

So, what’s happened since my Mid-Year Update? Not too much…here’s a quick recap and a look ahead to 2017:
  • 2017-to-do-list.PNGSince I renewed my licenses in 2016, I’m not due for renewal until 2018. I’m proud to say that I’ve already logged in 12 contact hours toward my 30-hour requirement for license renewal for my RN license. I do need, however, to step up my contact hours related to women’s health to meet my 45-hour requirement for my NP license! My goal is to complete 35 contact hours related to women’s health by 12/31/17.
  • I’ve decided that before returning to school, I’d like to get back to the bedside. What I really need to think about is “what does that mean?” Do I want to work as a staff nurse or nurse practitioner? In critical care or women’s health? My heart is leaning toward acute care, but I’m also considering inpatient hospice.
  • Regardless of what clinical path I decide to take, I’d like to get certified. Something new I discovered last year were ‘-K’ or ‘knowledge’ certifications, specifically for nurses or NPs who don’t provide direct care, but do influence patient care. I will definitely be looking a little closer at this opportunity.
  • Work-life balance continues to be a struggle, just as I’m sure it is for many of you. My cough is now under control, and the focus now turns to eating and sleeping right, and exercising more. I’m due for my annual gynecologic exam and mammogram, so I’ll be scheduling those ASAP.  
Now, back to my conversation with Michelle from INS. During our discussion, we came up with some insights to consider when using My Nursing Care Plan that I think are important to share.
  • Consider asking others – colleagues, family, friends – to contribute to your own care plan.
  • Waiting for the right time to get things done isn’t realistic. When is the right time? If you wait for it, it may never come.
  • Assess if multitasking really is in your best interest. Remember that it doesn’t work for everyone and it’s okay to do one thing at a time.
  • Be present. Whether at work or in your personal life, focus on the task at hand – whether it’s a true task or a personal or professional interaction.
  • Evaluate your care plan monthly, preferably about one week before month’s end. See what’s left to do and take a glance at plans for the next month. You can even set a reminder to do this on your phone or email.
What’s your update from the past year? Any goals for 2017 you’d care to share?

More Reading & Resources

 


 
Posted: 1/18/2017 7:16:37 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: InspirationEducation & Career


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