Journal of Nursing
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Mystery Diagnosis: Recognizing Serotonin Syndrome
Wendy Blatchley
Serotonin syndrome (SS) is a rare condition that is believed to be induced by ingestion of serotonergic medications, leading to an increased serotonin level. Although many medications are thought to be responsible, some of the more common are antidepressants and opioids. There are no definitive tests to confirm SS, therefore diagnosis is based on clinical findings and can be somewhat difficult. A triad of symptoms, neuromuscular hyperactivity, altered mental status, and autonomic hyperactivity, are considered the hallmark signs, but are not present in all cases. Symptoms can vary from mild and almost undetectable to severe and life threatening. Three diagnostic systems are currently utilized to assist with diagnosis if SS is suspected: the Hunter, Sternbach, and Radomski criteria. A diagnosis of SS should prompt discontinuation of the suspected offending agent. Increased awareness of this issue is needed, including symptoms and risk factors, so that the advanced practice registered nurse (APRN) may promptly recognize and diagnosis this condition to avoid further complications. Completing a thorough history and physical, along with accurate medication reconciliation can assist the APRN in identifying high risk patients. While there is still so much about SS that remains unknown, current information and education on this issue will ensure the APRN is providing safe and high-quality care. Databases utilized were CINAHL, PubMed, and ScienceDirect. These databases provide access to numerous nursing, biomedical, and scientific journals and were useful in locating up-to-date, peer reviewed research on this subject. -
What Can We Do to Promote Professional Socialization in Nursing?
Author 1: Nancy Bellucci, PhD, MSN, RN, CNOR Author 2: Shakeeka Misher, DNP, RN, RNC-MNN, NE-BC
Transitioning to a new work setting is challenging for many nurses regardless of the time spent in practice. Promoting professional socialization, through mentoring and precepting, helps to facilitate a smooth transition. Effective mentoring, using role play, reflective exercises, and debriefing, provides the transitioning nurse the opportunity to self-actualize his or her potential in the new work environment. The use of Benner’s Novice to Expert Theory and Duchscher's Stages of Transition Theory as a basis for mentorship enhances safety and quality in the provision of care. -
Case Study: A Systematic Approach to Early Recognition and Treatment of Sepsis
Madeleine Augier RN BSN
The term sepsis is often misunderstood. The public and often healthcare workers are unaware of the severity and high mortality rates this infection process has upon the world. Sepsis has vague symptoms that make diagnosis difficult. Often, sepsis is diagnosed in the later stages, when more obvious yet severe symptoms occur. This case study discusses a female who presents to the emergency department with sepsis secondary to pneumonia. Over the course of three days, the patient’s health quickly deteriorates, demonstrating the rapid progression of sepsis. Clinical findings, such as vitals signs, lab abnormalities, and symptoms of sepsis are discussed. The term bundle of care is presented to educate the reader on the golden standard of care for treatment of sepsis. This case study intends to increase community awareness and education to health care providers as well as providing an evidenced-based treatment guideline. More education and raised awareness will help prevent a deadly yet treatable infectious process. -
Evidenced Based Guidelines: Ischemic Heart Disease
Madeleine Augier RN BSN
Evidenced based guidelines to provide primary prevention and improve correct diagnosis and treatment. -
Ethical considerations for the mentally unwell in a global pandemic
Anthony Ragnauth
A case review on a mentally Ill patient during the covid pandemic. -
Importance of Interprofessional Collaboration, Communication and Teambuilding,
Kaitlin Graye, BSN, RN
Collaboration is especially significant in the healthcare environment to meet the increasingly complex demands of patients with multiple co-morbidities. This article discusses the importance of interprofessional collaboration, communication, and team building. -
Magnet Recognition: Is the Designation worth the Journey?
Gina Quinn RN,BSN,CPAN Jennifer Papapavlou RN, BSN, CCRN Heather Miller RN, BSN, CPAN
Currently, only eight percent of hospitals nationwide hold the title of Magnet Recognition (AHA, Fast Facts on US Hospitals, 2019) and even less receive consecutive designations. Eight percent is a marginally small number, especially when it comes to credentialing hospitals as havens for quality patient outcomes and centers of nursing excellence. The process of becoming a Magnet designated hospital is complex and grueling; requiring submissions of data, site visits, and taxes hospital resources in doing so. What then is this rare designation, and how does it improve both patient outcomes and nursing quality? Ultimately, does the designation provide benefit to those who obtain it? -
A Husband's Difficult Decision
Jennifer Kinneret Ron, BSN, RN, CPAN
A husband's difficult decision regarding his critically ill wife and DNR status -
Cardiomyopathy: A Closer Look at the Disease
Cherrie Deguzman, Heather Miller, & Brianne Gallagher
Heart disease is a wide term used for a variety of diseases that affect the heart. Heart disease is the leading cause of death in the United States. Cardiomyopathy is one of the types of heart disease that affects about 50,000 Americans annually. There are four types of cardiomyopathy: dilated, hypertrophic, restrictive, and arrhythmogenic right ventricular dysplasia (National Heart Lung and Blood Institute, 2007). This article will detail the different types of cardiomyopathy as well as the causes, treatment, sign and symptoms, diagnostic procedures and prevention. It will also cover ways to live with cardiomyopathy and end of life care. -
Love hate relationship in nursing
Luzyanna
My experience from a person who hated nursing to emerging as a qualified nurse. -
Nurses Eat Their Young; An Insight Into Systematic Hazing and its Implications on Patient Care
Shelby Leahy
I am a nursing student that worked as a CNA for six years. I was inspired to write this from my own experiences that I have encountered while working in the field of nursing. -
Retro-Clival Hematoma In The Pediatric Emergency Department
Richard. Pearson
An unusual presentation of Retro-clival hematoma in the pediatric population -
Rapid Response Team to the Rescue
Marina E. Bitanga BSN, RN, CCRN
Rapid response team purpose is to initiate immediate measures before patient deteriorates further and to educate the staff on activating the staff the Rapid response team -
Impact of Language Barriers on Patient Safety
Eva Vega-Gamez Stephanie Dumesle Jinsol Kim Mayara Silva Edith Claros, PhD MSN RN
This paper discusses how linguistic differences can contribute to patient adverse outcomes and the role of health care providers in mitigating the impact. -
Perioperative Fasting Guidelines as it relates to ERAS Protocol: Exploring Existing Modalities
Sarah Mensa-Kwao Cook
For the longest time, any procedure requiring anesthesia was accompanied with perioperative instructions mandating a fast from midnight until the surgery. However, anyone that’s lived long enough has learned to understand that just because something has been done for a long time, it doesn’t mean it should be done for the rest of time. With technological advances and improvements in research, medical practices and patient instructions should evolve. Here, we’ll explore the rationale behind the old modality as it pertains to preoperative care and instructions, what’s changed in research and technology, and finally, what new modalities should be learned, taught, and implemented. -
Electroconvulsive Therapy in Pediatrics
Stacey Kast Rn, Bsn
The use of ECT for the pediatric population requires significant application of professional ethics in order for the process to be smooth and successful. Experts who administer ECT on psychiatric patients ought to consider the right of the patient to choose the type of treatment they want after being equipped with all the pros and cons related to the process. -
Central Line Associated Bloodstream Infections
Stephanie Hopson
Evidence based practice for implementation of central line bundles to decrease central line associated bloodstream infections. -
Protein Consumption and Hydration in Competitive High School Students
Sabina Fidai Mackenzie Gavin Joseph D'Angelo Catherine Redler
The objective of this article is to provide a resource for nurses, coaches and athletes on proper consumption of protein and hydration status. According to the Institute of Medicine’s Dietary Reference Intakes, the Recommended Dietary Allowance (RDA) of protein for both men and women is 0.8 grams of protein per kilogram of body weight per day. The average athlete consumes more than the recommended amount of protein with protein supplements. The combination of increased protein consumption along with inadequate hydration can lead to short and long term consequences. Consequences include, acute and chronic kidney injury, rhabdomylosis, and electrolyte imbalances. Nurses play a vital role in primary prevention and education strategies in regards to proper nutrition. -
Compassion in Nursing; the “Gift that Keeps on Giving"
Mary Ellen Buechel Holbrook, RN, BA, BSN, CPAN
This article describes how, even in a busy recovery room, nurses who show compassion while caring for their patients, enrich their patients' experience by making a meaningful connection with them. -
Utilizing the “Teach Back” Method Approach in Reducing Medical Errors in Patients After Discharge.
Lise Anne Ross
This article is about the utilization of the teach-back method in reducing medical error and readmission with patients after discharge.