Patient Safety / Quality

Letters to the Editor – August 2008

Nursing pins, nursing pride  
I read the letter “Nursing school pin: Not for sale at any price” in your June issue with great interest. Like Theresa Stephany, I believe pins shouldn’t be sold to non-alumni. Last year when I toured St. Thomas’ Hospital in London, our guide proudly showed us the display of pins (which they call badges) from graduates of the London nursing school founded by Florence Nightingale in 1860. A “Nightingale nurse” is expected to will her badge back to the school on her death or take other measures to ensure it doesn’t fall into the wrong hands. The hospital’s display includes the name of each nurse. Wouldn’t it be a proud thing if American nursing schools created similar displays to celebrate their deceased alumni?
Sharon Jacques, PhD, RN
Candler, NC

The pin in one of the photos you ran with Theresa Stephany’s letter was from Villanova University. As a Villanova College of Nursing alumna, I’m wondering if our nursing pin was one of those Ms. Stephany found for sale on the Internet. I am very proud of the excellent education I received at Villanova and am disheartened to think a fellow alumna would have so little pride and connection to her nursing heritage as to sell it online. Please tell me it isn’t so!
Sherry Schacke, MSN, RN, FACHE
Commerce, GA

Editor’s response: Not to worry. The pins in both photos belong to American Nurse Today staff members and were photographed to illustrate the letter.

Safe staffing requires debriefing time    
I would like to comment on the role of stress in safe staffing. (“Safe staffing saves lives” by Rebecca Patton in the June issue). Members of other helping professions know they need daily debriefings to cope with work-related stress and stay healthy. Yet the nursing profession doesn’t use debriefing to ease the stress that comes with bedside nursing. As nurses, we are privileged to care for patients and families at moments of crisis. We truly make a difference—and I love being a nurse. But I’m not a machine. The caring and the crises cause stress. To retain our nurses, our profession should factor debriefing requirements into safe staffing levels. I’m calling for research on debriefing and for a significant restructuring to allow bedside nurses to become the best they can be.
Linda Cannon, BSN, RN, OCN
Dublin, OH

Lariam controversy  
Regarding “Are you prepared for malaria?” (June): My son, currently serving in the Peace Corps in Mozambique, was prescribed the antimalarial mefloquine (Lariam). A humanitarian traveler urged him to stop taking that drug and use atovaquone and proguanil hydrochloride (Malarone) or doxycycline instead. After doing much research on Lariam and reading e-mails from subscribers on the Lariam support-group website, I was able to convince him to switch to doxycycline. Here’s my message to all military personnel, Peace Corps volunteers, and travelers to areas where antimalarial drugs are recommended: Before taking a prescribed antimalarial, be sure to research the drug thoroughly. As for Lariam, please check out www.lariaminfo.org.
Pamela Maule, RN, CNOR
Iron Mountain, MI

From the editor: Clarification on malaria prophylaxis    
Reader Deborah Riehl, BS, RN of Lynnwood, WA, questions the statement in “Are you prepared for malaria?” (June) that chloroquine is the drug of choice for chemoprophlyaxis of Plasmodium falciparum malaria. Ms. Riehl states that “chloroquine-resistant Plasmodium falciparum is now the norm worldwide, and chloroquine is effective in only a few parts of the world. Doxycycline, mefloquine (Lariam), and atovaquone and proguanil hydrochloride (Malarone) have become the standard worldwide, although mefloquine resistance has developed in some parts of Southeast Asia. Please do not administer chloroquine in areas where P. falciparum is prevalent, or we’ll see more cases of imported malaria.”
In this article, author Barbara Chamberlain advises practitioners to review the patient’s travel destination to select an appropriate prophylaxis. For more information, see www.cdc.gov/malaria/travel/index.htm and wwwn.cdc.gov/travel/yellowBookCh5-MalariaYellowFeverTable.aspx.


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