1. Kennedy, Maureen Shawn MA, RN,


What nurses manage, both on and off the job.


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When I was growing up in New York City, the long, hot days of summer seemed to go on forever. My friends and I didn't go to camp; our families couldn't afford it. Instead, we spent August reading the books that sat on our desks all summer, and on the hottest days we went to the movies. In high school, when we weren't babysitting, my friends and I were hanging out and listening to transistor radios in the evening, biding our time until we were old enough to get our working papers. We were so eager to work!


Those days are long gone. Now, most of the nurses I know treasure their days off, but "personal days" tend to be as busy as workdays. That's when we manage the rest of our lives-errands, education, second jobs, volunteer work, family obligations, social engagements. I can't imagine being chronically ill or the parent of a chronically ill child on top of it all: visits to health care providers, trips for treatment, tracking and documenting everything and then wrangling over insurance coverage.


In this issue, Paula Harff Lomas and Susan B. Fowler report on their study of parents and children with cystic fibrosis (see "Parents and Children with Cystic Fibrosis: A Family Affair"). They found that of 66 patients with cystic fibrosis who also had a child with the disease, 59% were diagnosed during or after a pregnancy. (Lomas and Fowler decided to conduct their study after a patient was diagnosed with the disease only after her six-month-old was diagnosed.) Parents in such a situation face tremendous burdens, dealing not only with the news that their child has a progressive, inherited disease but also with the fact that they have it themselves. Also, they and their children face lifelong, daily therapy regimens, as well as shortened lives. And although a child can have cystic fibrosis only if both parents are carriers of the defective gene or one parent has the disease and the other is a carrier, 10 million people in this country are symptom-free carriers, according to the Cystic Fibrosis Foundation. Mandatory screening of all newborns wasn't required in all 50 states until 2009; in the coming years, many more cases will likely be detected. Lomas and Fowler's findings can serve as a reminder to nurses, especially those in maternity, pediatrics, and adolescent-health settings, that mild cases of cystic fibrosis can go undetected.


Nurses who have taken time out from their personal lives to benefit the environment and the public's health are also featured in this issue (see "Leftover Drugs in the Water Supply: Don't Flush Those Pills!"). Michelle F. Lauer and colleagues report on nurses' work in reducing the environmental impact of discarded drugs-especially those flushed down toilets that end up in our water supply as "organic wastewater contaminants." While no human studies have shown that discarded drugs lead to birth defects, there's some evidence of a link between estrogen contaminants in water (like those from discarded birth-control pills) and reproductive defects in fish.

Figure. Maureen Shaw... - Click to enlarge in new windowFigure. Maureen Shawn Kennedy

Lauer and her colleagues have worked to promote "take-back" programs, providing for the safe disposal of unused medications in communities in Maine and Delaware-methods that will keep the drugs out of our water supplies. Nurses Healing Our Planet, the environmental task force of the Delaware Nurses Association, partners nurses with pharmacies, hospitals, and law enforcement groups to launch take-back programs. The authors describe the environmental, legal, and financial hurdles encountered in hosting four events, at which they collected thousands of pills and many gallons of liquid medications. Lauer's colleagues in Maine worked with a county board of health, a community hospital, the Maine Department of Environmental Protection, and others to achieve similar results. Their article gives concrete advice to nurses wishing to join in this effort.


As these articles illustrate, nurses work hard and change lives, in large and small ways and in both their professional and personal lives. But it is summer: take some time for a real day off.