Sacred cows and road runners
American Nurse Today is one of the few publications I look forward to receiving, and I read it from cover to cover. It keeps me grounded in important practical and academic issues, is easy to read, and doesn’t steer away from controversial issues we need to confront.
I want to commend you on the Editorial in the April 2008 issue, “Sacred cow round-up,” and the article, “Challenging nursing’s sacred cows.” I carry this issue with me as I travel to hospitals across the United States to remind me of your important message: “We can’t afford to let sacred cows graze away our innovative thought and creativity.”
Nurses and nursing leaders must meet the current imperatives regarding care and care delivery. Times may seem tough now, but we’re only in rehearsal. The real show comes soon when demands from payers and consumers for low-cost, high-quality care reach levels we’ve never seen. Sacred cows—doing it the way we’ve always done it, ignoring trends, and thwarting innovation—are showstoppers for developing the new care models needed for highly performing hospitals of the future.
Thank you for highlighting this important issue. I’d like to challenge American Nurse Today readers to send examples of innovation and sacred cows put to pasture, so we can all learn from their experiences!
I see excellence breaking out everywhere and marvel at nurses who are road runners—the exact opposite of slow-moving cows. These nurses are our future…. Let’s champion their ideas, support their efforts, and amplify their successes. Let’s make leading practice our common practice. Our patients deserve nothing less!
Lillee Smith Gelinas, MSN, RN, FAAN
Editor’s note: We invite you to read “Challenging nursing’s sacred cows” at www.AmericanNurseToday.com/forum and post a comment. The Editorial, “Sacred cow round-up,” is available to all visitors in the Archives of our website.
When I read, “Teaming up to improve the quality of surgical care” in the May issue, I was surprised there was no mention of latex allergy and anaphylaxis prevention in the Surgical Care Improvement Project (SCIP) guidelines. As an advocate for latex-allergic people and a person with a severe latex allergy, I’ve witnessed the challenges that surgery poses for allergic staff members and surgical patients.
In 1992, I suffered an anaphylactic reaction to latex that almost took my life. We’ve learned a lot about the allergy since then, but there’s still room for improvement and education. Misunderstandings about the sources of exposure persist, and the general perception that the allergy has “gone away” puts all of us at risk. Adding latex-allergy prevention and management to the SCIP guidelines would be one more step in improving outcomes and safety for nurses and patients.
Renee Dahring, MSN, RN, CNP
When malaria requires apheresis
“Are you prepared for malaria?” in the June issue was excellent, and I’d like to provide some additional information on treatment. In 2005, I was fortunate enough to help save a husband and wife missionary team who had been to Nairobi, Kenya, and were infected with Plasmodium falciparum. After their diagnoses using blood smears, we started treatment with antimalarial drugs, but because of a tumor burden of 40% to 50%, these patients needed more than drugs.
Fortunately, the facility where I work has an apheresis unit, and we were able to perform a red blood cell (RBC) exchange (erythrocytapheresis) on both patients. During apheresis, a patient’s blood is drawn into the machine (usually through a central venous catheter), coagulated, and centrifuged. The patient’s RBCs are replaced by a donor’s RBCs, and the blood is returned to the patient.
After 5 days, the husband had a negative blood smear, and 2 days later, the wife’s blood smear was negative. Both recovered completely—and promised to take quinine sulfate prophylactically before their next trip to Kenya.
Judy J. Sigmon, RN, OCN
Correction: “Paget’s disease: A therapy update” (June 2008) mistakenly lists pamidronate (Aredia) instead of risedronate (Actonel) as an oral bisphosphonate. To download a corrected PDF, visit www.AmericanNurseToday.com.
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