1. Section Editor(s): Newland, Jamesetta PhD, RN, FNP-BC, FAANP, DPNAP

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November is a month filled with special days: daylight saving time, elections, celebrating our veterans, and Thanksgiving. What do these days mean for NPs as providers? First, for most of the United States, daylight saving time ends on Sunday, November 6th. With the switch to standard time, there are more hours of darkness and fewer hours of light during a 24-hour period. In an already sleep-deprived society, this change can trigger symptoms that mimic short-term, mild jet lag, causing disruptions in routine and energy for a few days as individuals readjust their biological rhythms.

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Daylight saving

Over an extended time with less daylight, however, some individuals might experience more pronounced symptoms suggestive of seasonal affective disorder (SAD), which can become chronic and recur annually. Symptoms associated with SAD include feeling sad, increased appetite, decreased energy in the afternoon with daytime sleepiness, loss of interest in activities, unhappiness, and lethargy.


The dread they feel each year as the fall season approaches is real for people affected and they are often depressed from the beginning of fall throughout the winter months. It is important that they are evaluated for other underlying mental health disorders so appropriate treatment can be initiated. In addition, suicide is a risk in persons who are severely affected.


The Presidential election and our veterans

Next on the calendar is Election Day, Tuesday, November 8th, and 2016 is a Presidential election year with higher stakes . The seemingly endless primary period and oppressive campaign can be psychologically energizing and/or emotionally exhausting. On Election Day, Americans start the ritual vigil, glued to some form of media into the wee hours of the night, waiting for results and final confirmation of winners. This year in particular, a noteworthy anxiety permeates lives across the country-who will be the 45th President of the United States? After the election, internal feelings and outward reactions/behaviors rest a lot on who wins.


Veterans Day follows on Friday, November 11th. We honor those living and deceased who have served our country. Healthcare for veterans has been a major issue among policy makers this year, especially in the Veterans Health Administration, with a bill to provide full-practice authority to advanced practice registered nurses working in the system (see "The Veterans Health Administration's proposal for APRN full-practice authority" on page XX).


Veterans often return to civilian life with serious physical disabilities and major mental health conditions; they need and deserve quality care and access to all types of providers who are able to provide that care. Likewise, armed service members, whether on active duty, reserve, or retired, and their families have special healthcare needs that can be effectively managed by NPs leading interprofessional teams. Our veterans deserve a special day of honor every day.



And last, but not least, is Thanksgiving. Families gather for good company, good food, and good times. Remind your patients that Thanksgiving is National Family History Day, first designated by the Office of the U.S. Surgeon General in 2004. As everyone gathers, families should seize the opportunity to talk about and record family health histories. Identifying one's risk factors for chronic health conditions is the first step in making changes to adopt a healthy lifestyle.


Taking action

There are several actions you can take with your patients to make it easier for them to get the conversation started. Give them a copy of their medical record, highlighting areas where they have questions and where you have identified risk factors. Share strategies on how to introduce a sensitive topic related to health with an individual or in a group. Refer patients to the U.S. Department of Health and Human Services' website where they can find tools to help gather and record information (


Celebrate all that is part of November. These four major days are intricately interwoven in our lives and the lives of our patients.


Jamesetta Newland, PhD, RN, FNP-BC, FAANP, DPNAP

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