Springtime is allergy season. No matter were you live, the changing seasons bring new outdoor and indoor allergens for people with seasonal allergies to cope with.
But while people sniffle and wipe watery, itchy eyes, there’s another allergy that isn’t always as visible, but incredibly serious. Life-threatening food allergies affect millions of people, are increasing, and can develop at any point in a person’s life. Severe reactions send about 200,000 people to the emergency room each year in the United States.
According to Food Allergy Research & Education (FARE), this week (May 13-19) is designated as National Food Allergy Awareness Week. Foods including milk, eggs, peanuts, tree nuts, wheat, soy, fish, and crustacean shellfish are the culprits behind the majority of food allergies in the United States, but many people have allergies to other foods. While some reactions are immediate and obvious, others are more subtle. As a nurse on the front-lines of patient care, it’s important to consider food allergies when presented with new and undiagnosed symptoms.
According to FARE, common symptoms of allergic reactions to food include:
- Itchy mouth
- Nausea/vomiting/stomach pain
- Nasal congestion or stuffiness
- An odd taste in the mouth
- Difficulty breathing
- Throat tightening
- Loss of consciousness
- Turning blue
- Weak pulse
Taken alone, each of these symptoms could be attributed to many other illnesses or reactions. But as each exposure to a potential allergen can cause a more severe reaction, it’s prudent to make sure you consider food allergy for patients presenting with these symptoms.
If you or the patient suspect food might be triggering the symptoms, help guide them to proper allergy testing and tips on how to avoid the allergen. Instruct them to call 911 if they suspect an allergic reaction to food as the reaction can be unexpectedly sudden and severe. Help determine an appropriate care plan for the immediate future to keep the patient aware and as safe as possible.
Becoming more aware of food allergies and what reactions might look like is another tool in your nursing toolbox that could help save a life.
Every year, National Neuroscience Nurses Week is celebrated in the third week of May. The week honors nurses who dedicate themselves to this field and to the patients and families impacted by everything from severe head trauma to stroke.
Neuroscience nurses focus on the brain and the injuries and diseases that impact this essential and highly complex organ. With the rapid-fire developments in the field and the distinctive ways each person’s brain responds to any kind of disruption, neuroscience nurses’ skills are always evolving.
The American Association of Neuroscience Nurses, which has local chapters throughout the country, helps nurses with professional development, networking, and staying current with the latest trends and technology in the field. As a professional organization, it offers information on how nurses can obtain Certified Neuroscience Registered Nurse (CNRN) certification or a Stroke Certified Registered Nurse (SCRN) certification.
Neuroscience nurses care for patients who are vulnerable and who sometimes have injuries or diseases that have an uncertain prognosis. They may care for patients who have newly diagnosed multiple sclerosis, advanced Parkinson’s, encephalitis, or have recently suffered a mild or severe stroke. They may treat those who have been in a serious car accident and suffered a head injury or someone who has a neurological injury from a fall. They might also plan out care and treatment for patients with epilepsy or recovering from meningitis.
While caring for the patient, they must help families cope with the uncertainty or the potentially long recovery, and they also must guide them in the care they will need to provide to increase the prognosis for each patient. The patients might need occupational, speech, or physical therapy to relearn how to do many activities of daily living, and nurses will work with those teams as well.
Because of the variety of needs for neuroscience nurses, the field has potential job openings in many settings including hospitals, rehabilitation centers, nursing homes, and trauma units. An aging population also increases the demand for neuroscience nurses as various illnesses and conditions impact an aging brain.
Neuroscience nurses must have excellent critical thinking skills as each patient will respond differently to therapies and treatments. They also have many ways of helping and engaging both patients and families to improve outcomes.
Thank a neuroscience nurse in your life this week!
Today’s celebration of National School Nurse Day is recognition that school nurses are an integral and essential part of any school community. And while a school nurse’s mission has remained steady over the years, the job responsibilities and job duties have not.
Doreen Crowe, MEd, BSN, RN, is on the board of directors for the National Association of School Nurses and is the Director of Nursing Services for the Wilmington Public Schools in Massachusetts, says the role of today’s school nurse has changed over the years.
“School nursing is a special role that involves managing the health and wellness needs of school-aged children,” she says. “Many children attending school have chronic and acute health conditions. It’s my job to insure these students are receiving necessary support to be in school, safe and ready to learn.”
Children and teens require support to have a good day at school and that can mean a school nurse is there to oversee all kinds of care. “It involves providing care coordination, leadership, standards of practice, quality improvement, and community/public health,” says Crowe, who has been in her role for 16 years. “The ultimate goal is connecting school health with academic success.”
When each day is different, Crowe says planning and time management become both crucial and one of the biggest challenges. “You never know what each day will bring,” she says. “During a typical day, the school nurse can be seen multi-tasking. One minute, she’s assessing a student for illness complaints. Then she’s seeing a student with a scraped knee from recess, followed by a student who recently lost a parent to substance use.”
And the landscape of who is bringing up kids is changing. “It’s also becoming more typical for grandparents to be raising their grandchildren,” she says. Dealing with multiple caregivers and different generations of caregivers becomes a masterpiece of coordination and communication. And when a school nurse is informed of and sensitive to any changes or challenges in a home environment, he or she can help the child with proper resources and support.
School nurses today are more likely to have access to data to determine the types of care they are providing, the number of children who go home early, or how many children with mental health diagnosis is changing. Using this kind of solid information can inform their practices, but can also offer the district administration insight into what a school nurse is dealing with on a regular basis.
And while roles change and responsibilities become more complex, school nurses come to school ready to offer care, comfort, medical services and guidance, and even a spare set of clothes when needed. “The school nurse is always ready for an emergency,” says Crowe, “and is prepared for multiple scenarios.”
Student nurses don’t need anyone to tell them their lives are busy. With school, work, families, and a personal life, many student nurses are juggling more than most people. Tamar Rodney, MSN, RN, PMHNP-BC, CNE | PhD-c, is a Geneva Foundation/Jonas Veterans Healthcare Scholar 2016-2018 at the Johns Hopkins University School of Nursing and is no exception.
To celebrate today’s observation of National Student Nurses Day, Rodney gave some insight to what life is like for a graduate student in nursing school. As a PhD candidate in nursing, she has been through the rigors of nursing school for a while. What she knows is that her dedication and the time spent on her education is going to bring her to the place she wants to be. Along the way, says Rodney, the journey itself is pretty amazing.
“I love being a nurse, and having the opportunity to make someone’s day or life better,” she says. “I felt drawn to nursing because I admired my memories of childhood reactions to nurses. Their presence meant someone was here to help. I have always carried that image with me of bringing a sense of comfort, security, and a sense of care to someone else.”
Rodney knew going for her PhD would be hard work, but she says her patients were her inspiration and continue to be the motivation to learning as much as she can. “My journey to pursue a PhD was influenced by the day-to-day care of my patients,” she says. “I saw problems that were not addressed and felt like having concrete research would be a good way to start being able to answer those questions.”
And while continuing her education is far from easy, it has brought her a level of satisfaction and of personal and professional growth. “Graduate school is as challenging as I thought it would be,” she says, “but I also got the opportunity to think independently and explore questions that I was interested in. I could finally expand my thinking about ways to provide better care for my patients. I also saw the direct link and importance of collaborating with other healthcare providers and disseminating research for implementation at the bedside.” Eventually, she says, she would like to combine the teaching, research, and practice areas of nursing into one career.
Rodney completed her LPN and RN at Dickinson State University in Dickinson ND, and she started out her career as an LPN working in a nursing home. “I loved it,” she says, “and felt like I would get a new history lesson every day I went to work.” From there, she worked in inpatient psychiatry, primarily to learn more about mental health and how better to approach treatment and diagnosis. It was during that time that she began her MSN program at the University of Vermont.
Discovering a new passion for mental health, Rodney took advantage of certification and gained her psychiatric mental health nurse practitioner certification. “I recently completed my PhD studies at The Johns Hopkins University, exploring biomarkers for PTSD in military personnel and veterans with traumatic brain injuries.” All of her studies are helping her get closer to where she wants. “My ultimate goal is to change the way we approach diagnosis and treatment of mental health disorders,” she says.
Like nursing practice, a nursing career isn’t done in a vacuum. Joining a professional organization (Rodney belongs to the Graduate Nursing Student Academy) is a way to network and share resources with other student nurses. “Having completed my program I now have a large network of other young professionals with whom I can collaborate and have as supportive resources,” say Rodney.
And graduate school itself offers opportunities for growth that are unexpected, because you are finding the answers but also beginning to ask the deeper questions. “Graduate work in nursing is a unique way to advance one’s personal understanding of nursing practice, an opportunity to deliver the best care possible and advance nursing research and practice,” she says. “You can explore those questions that you have an interest in and explore innovative ways to answer it.”
As part of National Nurses Week, Minority Nurse is exploring the many paths nurses take to find a career where they feel like they are making an impact.
Irma Teune, BSN RN MSCN CCM is a bilingual clinical nurse educator with Horizon Pharma where she educates patients and families about chronic granulomatous disease (CGD), a rare primary immunodeficiency disease in which the body is especially susceptible to infections from bacteria and fungi.
As frightening as it is to learn you or a loved one has CGD, it can be even more difficult to understand when your primary language is different from that of your medical team. Teune’s ability to speak comfortably in Spanish and English means she can put her patients at ease while giving them the exact information and guidance they need to manage the disease.
Minority Nurse asked Teune some questions about her career path and how she is making a difference as a nurse.
1. How did you discover the field of nursing was right for you?
Like most people who pursue a nursing career, my primary passion is helping people living with chronic illness – and for me, my sister inspired this desire in me. When I was 27 years old, she was diagnosed with multiple sclerosis. It was an overwhelming time for our whole family – I received many questions from my family and her husband concerning her diagnosis and treatment since I was a registered nurse. The more I became involved with my sister’s health, the more I understood the perspective of family members of people with chronic diseases, and how the lives of caregivers are often just as impacted as the patients. I recognized the effect a caring, understanding nurse could have on patients, as well as their families, by playing that role within my own. I wanted to be part of that positive impact for patients and their families!
2. What led you to becoming a clinical nurse educator?
I first became a CNE for an MS therapy – because for me, it really was personal. I was very knowledgeable in MS diagnosis and treatment, so it was a natural fit for me to move into this role. After about six years, I was looking for a change and pursued an opportunity with Horizon Pharma. I’m now part of a support program for people who are prescribed Horizon’s therapy for chronic granulomatous disease (CGD), a primary immunodeficiency that only 20 children are diagnosed with in the U.S. each year.
For families impacted by this rare disease, it can be difficult to find a healthcare provider that is familiar with the disease, which only increases their fears. And their fears usually stem from not knowing what to expect next or how to manage the condition. That is why educating these patients and their families about CGD is so rewarding for me – it’s the first step to helping them become confident in handling any challenges that may come their way. I not only help patients manage their treatment plan, but also ease some of the burden that comes with being a caregiver. For example, my patients and their families can contact me with any issue—whether it is an insurance question, or a concern about the patient’s health, I will look into the matter and connect them with the right resources. I love it.
3. As our global community becomes increasingly smaller, many people may receive treatment in a place where they do not speak the primary language. How does that barrier impact everything from their ability to decipher a care plan to their hope for a good outcome? How is that magnified when the diagnosis is complex or a rare disease?
For any patient, it can be difficult to understand the complexities of their health and the healthcare system, as well as find the resources to support the best possible outcomes. These issues are further complicated when you are not a native speaker of the language of where you are being treated, as clinical details and context can get lost across multiple channels of communication. Language barriers also inhibit the trusting and positive relationship between the patient and provider that is so important for effective treatment.
For patients with a rare disease like CGD, because the affected community is so small, basic information is relatively limited – even in English. That’s why it’s so helpful for patients to have someone in their life who can talk knowledgeably about their disease in their language. Speaking to someone in his or her own language breaks down the walls that surround them and helps minimize the barriers they face in accessing and understanding their therapy. Even better – it provides them assurance and confidence that everything is going to be okay.
4. As a bilingual CNE, how do your experiences with patients help elevate the work you do? How does it help the patient and the families who are affected by diseases?
As a bilingual CNE, the obvious benefit is that I can communicate with Spanish-language patients in their native language. This helps ensure they are able to successfully adhere to their treatment plan. Additionally, I can help identify issues related to a patient’s or caregiver’s cultural needs. With the trust I’m able to build with my patients and families, they’re able to fully express questions or concerns, and I can ascertain their level of comfort and comprehension in managing their condition, avoiding further difficulties down the road.
Most importantly, I can be more effective in giving patients and families the reassurance they need. Imagine a patient or family member is worried about their treatment coverage or health, and hears, “Hola, como estas,” when they reach out for help. Or, when I give a patient the confirmation that everything is going to be okay, “Todo saldrá bien.” It’s these nuances that can make all the difference for a patient’s or caregiver’s treatment experience. And I love bringing this insight and experience to my broader CNE team. My colleagues and I work so closely that to be able to share the experiences of our bilingual patients feels like an honor.
5. What gives you the greatest joy as a nurse and what is your greatest challenge as a nurse?
As a Horizon CNE, I support my patients for as long as they are taking CGD medication, which for many, can be for life. Even when patients do feel confident with their treatment plan, or when children gain more independence, I am always available for help and to answer any questions. One of the most rewarding parts of my job is seeing a patient grow, and not just in their disease management. CNEs often play a role for every important milestone, from a child’s first day of school to teaching a college student how to inject their medication on their own. We get to know our patients on a more personal level, and are able to share in their accomplishments and joys as well.
Rare diseases can be difficult for even the most experienced doctors to diagnose. Likewise, with CGD, it can be confused with other inflammatory or infectious diseases, as they share many of the same symptoms (such as fever, tiredness, abdominal pain, weight loss, swollen lymph nodes, etc.) Unfortunately, by the time these patients are correctly diagnosed, they are often exhausted and scared. Sometimes patients and their families feel dismissed by the healthcare provider’s inexperience in CGD to be able to recognize the condition or its severity. As a result, when I reach out to a new family, they may be wary or tired of their journey and not being heard by the clinical community. As I only work with CGD patients, the condition is basically my whole life; I work hard to assure these families that I understand and can validate their struggles, and that I will help them in any way that they need me.
6. If others are thinking of a career as a CNE, what kinds of education, experience, and expectations might they have?
As a CNE, you need to be just as passionate about educating patients and their families as you are about listening to them. For most people living with a rare disease, the journey to diagnosis can be long, arduous and lonely. Some patients dive into research when they are diagnosed, and others take more time to process everything, so I always let them share what they are going through to determine how I can best educate them.
It’s important to allow patients to share their thoughts and feelings, and to hold their hand through the experience and acceptance of their condition. It’s this openness and transparency that is so critical to improving treatment outcomes, and helping patients get the most out of the services I can provide.
7. What will you reflect on during National Nurses Week?
This National Nurses Week, I will be reflecting on how rewarding it is to watch patients and caregivers develop from uncertain newcomers to advocates for the rare disease community. While I only work with the same 50 or so patients, I know that the impact I have on their families’ lives is far-reaching.
For example, I recently met with a young man who is preparing to go to college to teach him how to inject and responsibly take care of his medication, helping him gain more independence. Additionally, one of my newer patients is a six-month-old child. I met with the child’s grandparents and guardian, who were understandably very nervous and worried for the child’s well-being. Seeing them more positive and hopeful at the end of my education session reminded me again of why I love what I do. Reflecting on my patients’ successes and growth fills me with pride, and reminds me of my own accomplishments in my career.