Lead: A Threat to Children and Adults Alike

Bridget Seelinger, DUSNA Publicity Chair

The disaster in Flint, Michigan has raised awareness for rising levels of lead in drinking water. Some reports say that our very own Allegheny River may have near-toxic levels of lead in the water, which raises questions as to how much this can affect one’s health.

What makes the situation in Flint so perilous is the fact that the lead that is in the water is originating from the pipes. In 2014, the town’s water source was switched from Lake Huron to the Flint River. Pipes were used that were not properly treated against corrosion, so throughout the years, the pipes have worn down and leaked literal poison into the water. There are very legitimate fears that the high levels of lead in the children of Flint’s bloodstreams, may lead to permanent neurological damage. The state of Michigan, the Environmental Protection Agency, and the federal government are seeking to waterprosecute the officials responsible for the decisions that led to the water crisis.

Lead works as a poison in the body, mimicking the actions of important vitamins and minerals such as calcium, iron, and zinc. As a result, lead can cause severe mental alterations as the brain has decreased oxygenation and decreased muscle function, since calcium is vital for healthy muscle contractions. Lead is odorless, tasteless, colorless, and virtually undetectable until symptoms start to occur. The only way that lead can affect you is if it is ingested, which is why it is important to check one’s home for lead paint, especially if there are children in the home.1

After reports indicated high levels of lead in Pittsburgh water sources, the Pittsburgh Water and Sewer Authority (PWSA) began testing our own pipes for corrosion and came up with a safeguard against the poisoning of our water supply, the decision to switch from caustic soda to soda ash, a chemical that will create a film over the pipes to prevent corrosion.

In a report by the Pittsburgh Post-Gazette2, John Jeffries, supervisor of the county health department’s Public Drinking Water & Waste Management Program, said, “I think this is a good opportunity for people to understand the water systems of Allegheny County have been using the same sources for a very long time, and they are comfortable treating those to meet rules and regulations… For what it’s worth, I drink the tap water.”

Symptoms of lead poisoning in children include developmental delays, irritability, hearing loss, nausea, vomiting, abdominal pain, loss of appetite, and weight loss. In adults, symptoms include high blood pressure, muscle pain, joint pain, decline in mental functioning, miscarriages, and constipation. If you present with the symptoms above, it is important to get help right away.  Treatment for lead poisoning is Chelation Therapy, a process of ingesting a chemical and excreting the lead through the urine. In severe cases, EDTA therapy is used, where an even harsher chemical is used to excrete the lead.3

It is important for people to understand the true danger of lead, especially lead in the drinking water, and be vigilant for signs and symptoms of possible toxicity. Hopefully, as the investigation in Flint continues, proper actions may be taken to resolve this very critical issue.

 

 

 
1, Delaware Department of Public Health: http://dhss.delaware.gov/dhss/dph/files/leadpoisonfaq.pdf

2, Pittsburgh Post-Gazette: http://www.post-gazette.com/local/city/2016/01/22/Pittsburgh-water-sewer-authority-using-new-lead-fighting-chemical/stories/201601220121

3, Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/lead-poisoning/basics/definition/con-20035487

Photos from NBC and Wikipedia

 

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Stuck In Line: The Psychiatric Bed Crisis

Bridget Seelinger, DUSNA Publicity Chair

The Pennsylvania Medical Society is calling for legislation regarding the ability to find inpatient beds for psychiatric patients. During the society’s annual House of Delegates, 200 physicians endorsed the idea of creating a voluntary bed-tracking system for the entire state, so that patients can be placed in a psychiatric facility faster and more efficiently. State Representative Dan Miller- D. Mt. Lebanon has introduced a bill to address this concern, but the legislation hasn’t gotten anywhere, to the frustrawestern psychtion of supporters.

When a psychiatric
patient presents to an emergency department that patient can remain waiting for placement in a facility for hours, sometimes even days.  According to Bruce McLeod, President of the PA Medical Society, there is a dire need for reform.

“Quite often, psychiatric patients experiencing a health problem will end up in the emergency department. When that happens, it is important to find them appropriate care quickly,” he says, “It’s not unusual for a psychiatric patient to spend hours in the emergency department while staff members try to track down an available bed.”

MSNBC reported back in 2013 about the bed crisis that has been affecting all of America, not just Pennsylvania. According to the story, state budget cuts and the movement of care into the community have left questions as to what patients are supposed to do while in between the inpatient and outpatient settings. The answer? Languishing in the ER until a bed opens up.

Many states have chosen to downsize the amount of beds open in an effort to place more emphasis on community resources by the closing of state hospitals. In states like Minnesota, this has resulted in the “warehousing” of committed psychiatric patients into catch-all psychiatric units in hospitals unequipped to deal with this patient population and unable to properly treat these patients. Patients end up waiting in these units for months instead of getting the treatment that they need. County jails have also been filling up with patients in Minnesota, sometimes taking higher spots on waiting lists and further clogging up the system.

“This is about as bad as I’ve ever seen it,” said Roberta Opheim, Minnesota’s state mental health ombudsman. “People [hospitalized with severe mental illnesses] have no place to go, but they can’t just be put on the street.”

According to the Pittsburghmental health Post-Gazette, though, the problem isn’t that there aren’t enough beds available. The problem is that no one knows where these open beds are.

The Allegheny Health Department reports in most recent figures that psychiatric hospitals within Allegheny County have occupancy rates of 59.5-94.3%. The hospitals are not completely full, yet patients are still left waiting.

Camellia Herisko, Chief Nursing Officer and Vice President of Patient Care services at Western Psychiatric Institute and Clinic says that UPMC is working on a system for UPMC and non-UPMC emergency departments.

“Bed availability can be challenging. So to ensure we are providing the most effective care to our patients, we are developing new and creative strategies to address this,” she says.

These sorts of systems are not a miracle fix for the problem, though. Iowa instituted a statewide database and is currently running into problems because facilities will not report open beds.

Natalie Shea, the Emergency Service Manager at Central Community Hospital in Iowa says that the problem of open beds is unique to the mental health community because of the way that treatment is handled.

“The timely care of the patient by trainemergency_roomed staff and facility is so key to the success of treatment for these patients and we have not solved that issue at all,” Shea reports, “We need more access closer to the patient’s home.”

Delays in treatment have been shown to negatively impact the recovery of mental health patients who are in crisis. So much so, that HMO giant, Kaiser Permanente, has been fined millions in damages by the State of California for delaying the treatment of hundreds of patients. Kaiser Permanente has made improvements in staffing and other resources to address these concerns, but California recognizes the importance of prompt treatment.

US Congressman, Tim Murphey-R. from Greensburg chaired a committee that was tasked with dealing with the bed shortage issue across the states.

“We have replaced the hospital bed with the jail cell, the homeless shelter and the coffin,” he said, “How is that compassionate?”

How long must our psychiatric patients be kept waiting?

 

Sources:

Jordan, E. (2015, September 25). Iowa’s mental health bed-tracking database ‘not useful’ so far, hospitals say. Retrieved January 27, 2016, from http://www.thegazette.com/subject/news/government/iowas-mental-health-bed-tracking-database-not-useful-so-far-hospitals-say-20150925

Khimm, S. (2013, December 02). Not enough beds for the mentally ill. Retrieved January 27, 2016, from http://www.msnbc.com/all/no-beds-the-mentally-ill

McLeod, B. (2014, January 16). Statement: National Emergency Care Report Card Shows Need for Better Pennsylvania Effort on Psychiatric Bed Shortage. Retrieved January 27, 2016, from http://www.pamedsoc.
org/FunctionalCategories/About/Media/Psychiatric-Bed-Shortage.html

Olson, J. (2015, November 2). Shortage of state psychiatric beds leaves local hospitals jammed. Retrieved January 27, 2016, from http://www.startribune.com/shortage-of-state-psychiatric-beds-jams-twin-cities-hospitals/339185701/

Pfiefer, S., & Terhune, C. (2015, February 24). State again faults Kaiser Permanente for mental health treatment delays. Retrieved January 27, 2016, from http://www.latimes.com/business/la-fi-state-faults-hmo-giant-kaiser-permanente-mental-health-care-story.html

Psychiatric bed shortage stressing ERs. (2013, October 28). Retrieved January 27, 2016, from http://www.sciencedaily.com/releases/2013/10/131028100857.htm

Smydo, J. (2016, January 25). Finding beds for Pennsylvania’s mentally ill difficult even when available. Retrieved January 27, 2016, from http://www.post-gazette.com/news/health/2016/01/25/Finding-beds-for-Pennsylvania-mentally-ill-difficult-even-when-available/stories/201601170009

Stazbo, L. (2015, April 12). Cost of not caring: Nowhere to go. Retrieved January 27, 2016, from http://www.usatoday.com/story/news/nation/2014/05/12/mental-health-system-crisis/7746535/

Image from CBS Local and WPNR

Nurse-Patient Ratios: A Problem Yesterday and Today

Brooke Calta, junior

Rising acuity of patients and shorter hospitals stays over the past few years can only mean one thing… a growing need for registered nurses. The continually growing shortage plus reductions in hospital nursing budgets means another thing…fewer nurses working longer hours (*nursing students cringe here*).  Because of the shortage, there is a huge concern regarding nurse to patient ratios and the safety risks associated with it. Besides the risks for patient safety, poor ratios can negatively impact the mental and physical well-being of nurses.

ratiosAccording to the American Nurses Association, 50% of nurses report that they aren’t able to spend enough time with patients, and 33% of nurses report that staffing levels are simply inadequate.  This feedback from caregivers themselves is evidence that workloads of nurses are becoming heavier, and burnouts are becoming all too common. Inadequate staffing, and therefore increased stress in employees, has been shown to result in increased medication errors, nosocomial infections, injuries, and even longer hospital stay. So by reducing nursing budgets, hospitals end up paying additional funds for adverse events? Makes sense.

Steps are slowly being taken. In April of 2015, the Registered Nurse Safe Staffing Act was introduced by 3 members of congress which requires Medicare-participating hospitals to have a committee made up of at least 55% of direct patient care nurses to create staffing plans for each unit. According to the ANA, there is a staggering 20% decrease in hospital deaths when nurses are a part of the staffing committees…wrap your brain around that one.

What can nurses, or any healthcare workers, do to make matters better? Write to your congressional representatives and push for more legislation to improve nurse staffing. Take your personal experiences related to short staffing and share them with the ANA as they take steps towards legislative success. Lastly, encourage friends, family, and co-workers to take action as well. As legislation develops and hospitals step of their staffing game, nurses’ workloads will be lightened, their bodies will be less fatigued, they will stick around longer and likely be more satisfied with their role in helping others. More importantly, patients will be more satisfied with their care, and additional lives will be saved.

 

Photo from the American Nurses’ Association

 

Success at SNAP! DUSNA Achieved in Harrisburg

Holly Storm, freshman

Hundreds of student nurses coming from all different programs and schools met in Harrisburg Pennsylvania on November 18th to November 20th  for the Student Nurses Association of Pennsylvania Annual Convention. During the days of convention, the student nurses went to business meetings, keynote speakers, workshops, resolutions hearings, and candidates’ presentations. Each school that was attending the conference had delegates able to vote in the matters brought to the convention.

The business meetings were three meetings throughout the two main days of the convention. The first meeting was to call to order the convention, bring up opening matters, and ask if anyone wanted to run for a position on the board of directors. The second was to make sure no one else wanted to run for a position, and the final meeting was to vote on the resolutions and announce the new board of directors.

The keynote speaker at the convention was Dr. Loretta Sweet Jemmott who spoke on her experiences to becoming a leader in nursing. Dr. Jemmott is the Vice President of Health and Health Equity and Professor of Health Professions at Drexel University. She has worked with HIV/AIDS prevention and how to develop, facilitate, and promote positive changes in health behaviors. Her speech was invigorating and inspiring.

There were two sessions of workshops throughout the two main days of convention. The first session had four topics to choose from including “Your Journey and Your Ride: Becoming the Leader You Want to Be”, “No Capes Needed, Finding the Courage to Lead: Conquering Challenges to Reap Rewards”, and “Hate Having a Boss? Me, Too! Start Your Own Company”. The Second session of Workshops included “PA Action Coalition: Championing Nursing’s Future, Building Your Own Yellow Brick Road”, and “Diversity in the Nursing Workforce and Why it Matters”. All the topics in the workshops dealt with leadership in the nursing field whether it be the challenges that will be faced on the way or how to deal with the fear that comes with being a leader in the nursing field. These workshops were very helpful for career planning and I found myself intrigued by many of the topics.

The resolutions and candidate’s presentations were a large majority of the last day of convention. The candidates for each position had to give a two-minute speech on why they are running and what they can do the SNAP board if they are elected. After the speeches were given there was Meet the Candidates and voting. Then there was the resolutions hearing where eleven resolutions were brought before the delegates and presented. This included a reading of the resolved statements, or what the authors should be done about the issues written about, and an opening statement given by the authors. Though there was also time to debate the resolutions, there was almost no debating and amazingly all eleven resolutions were passed. DUSNA’s resolution on intersex infants was passed with unanimous support.

When the election results were revealed, there was a dramatic overturn in SNAP leadership with Vice President, Marcus Henderson routing Meghan Long, the incumbent, for President. This was especially surprising, considering all of the successes of SNAP this past year. DUSNA was happily surprised at the Awards Banquet to receive several accolades for both individual members and the organization as a whole. The Scope’s own, Sarah Dudley received a SNAP Freshman Member Scholarship and Bridget Seelinger received the Jamey Thiel Miller Memorial Legislative Award for being active in nursing and politics. DUSNA was awarded a Gold Category Award for Recruitment and Retention and was the only chapter in the state of PA in level 2 to receive the Chapter Excellence Award, a highly coveted award amongst SNAP chapters. It was a highly successful SNAP convention with successes for DUSNA all around!

The SNAP convention can seem very overwhelming to those who have never been before, but it is a worthwhile experience. All the speakers who were at the convention were inspiring and as much of a success it was this year, it will only keep getting better throughout the years.

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Midyear, an Outstanding Start to a Nursing Career

Bridget Seelinger, DUSNA Publicity Chair

Duquesne sent three representatives to the National Student Nurses Association annual Midyear Career Planning Conference, held in the Hyatt Regency in downtown Atlanta earlier this month. It was a fantastic conference filled with workshops, inspirational lectures, networking opportunities, and delicious southern food.

After cruising into Atlanta’s airport in the early afternoon of November 5th, Duquesne headed to a Pharmacology Made Insanely Easy workshop where they learned fun techniques for remembering complicated lists of drug interactions and side effects. Some of these techniques involved Pharma-karaoke and mnemonics. It was a fun workshop and very helpful for the Pharmacology HESI test!

The keynote address was next and it was one of the most powerful keynotes that NSNA has had in a while. Called “Compassion Energy- the Honor of Caring” and presmidyear2ented by Sally Karioth who is the assistant dean of Florida State University School of Nursing, this speech had an impact on every member of the audience. Karioth spoke about her experiences as a nurse working in the early days of pediatric oncology and how she learned the importance of providing for the family, as well as the patient. She said that what separated nurses from “little doctors” was this aspect of caring and empathy, and being that patient advocate. The audience was simultaneously laughin
g and crying as she talked about the grieving process and the nurse’s role in that process. It was an amazing speech which was only made more impactful by what followed it.

Following this incredible speech was a memorial service for the five Georgia Southern University nursing students who were killed in an automobile accident as they returned from clinical. Friends of these students spoke about the lives of their friends and one of the first responders spoke about how this accident has affected her nursing career. It was a very moving ceremony.

The next day included the grand opening of the exhibit hall where students were able to mingle with potential employers and explore educational opportunities. There was a general session called “Emerging Infectious Diseases: Global Impact- Local Consequences” which featured Crystal Johnson, one of the nurses who cared for the Ebola patients in Atlanta and Mary Lou Manning who is president of the Association of Professionals in Infection Control and Epidemiology. Both spoke about their experiences with Ebola and Johnson, in particular, provided some inspirational insight as to why she chose to take care of patients who were sick with something as dangerous as Ebola. She spoke about how the nursing staff provided for the psychosocial aspect of these patient’s care such as playing games with the patients and holding their hands. The rest of the day concluded with co-current sessions which featured topics for career building and improving one’s local chapter.

The final day of the convention notably included nursing specialty panels where students could hear about a variety of nursing specialties including but not limited to Neonatal Nursing, Forensic Nursing, Nurse-Midwifery, Critical Care Nursing, and Holistic Nursing. It was very helpful and informative for students considering graduate school. Following the panels, there were sessions on Human Trafficking, Bylaws and Policies, Nurse Safety and Patient Care, and NSNA Leadership. All of these sessions were very informative and intriguing.

The Midyear convention was a fantastic way to get advice for career planning and discover unique opportunities within nursing. It was also a great to hear from inspirational nurses within the profession, not to mention how fantastic it was to be in downtown Atlanta! Midyear convention was a lot of fun and highly suggested next year!

Importance of Down Syndrome Awareness

Brooke Calta, junior

Melissa Reilly works as an inspirational speaker and a teacher and is a gold medal skier, cycler, and swimmer. Sujeet Desai graduated from Bershire Hills Music academy, plays seven instruments and was featured in Time Magazine and the Wall Street journal. Michael John works as an artist who has sold more than five hundred portraits and had a solo gallery at Vanderbilt University. His paintings were featured on the cover of the American Journal of Public Health.

What do these tdownshree individuals have in common besides seemingly successful careers?

All were born with Down syndrome.

Students who are enrolled in basic high school science courses usually get some basic genetics concepts drilled into their mind:

“Chromosomes are rod-like structures that are made of genes.”

“Genes carry codes for inherited traits.”

“A mutation of a chromosome can cause a physical or mental change in an individual.”

“Down syndrome is called Trisomy 21 because of an extra copy of a chromosome on the 21st pair.”

Sure, many Americans know what causes Down syndrome, but are we as a population aware of what it truly entails?

Roughly 1 in every 700 infants are born with D
own syndrome. The birth defect alters how the child’s body and brain grow, and causes both physical and intellectual challenges. If diagnosed at birth, health care workers look for a single deep crease in the palm of the infant’s hand, a slightly flattened facial profile, an upward slant to the eyes, and low muscle tone in addition to blood tests for genetic testing.

Despite somewhat similar appearances and tendencies, people with Down’s have varying abilities, unique to each individual. According to The Arc.org, children with Down syndrome can show few to several signs. In essence, an affected individual is typically more similar to the average person in a society than different. Contrary to several common myths, most people with Down’s can develop athletic abilities, learn to read and write, attend public school, and live independently.

Why should we care about Down syndrome? Fortunately, people with Down syndrome are living much longer lives because of advances in medicine and technology. With the increased life expectancy comes an increase in the number of affected individuals in the work force, health care settings, and schools. Therefore, it is imperative that Americans be not only educated, but accepting.

Like Melissa, Sujeet, and Michael, many people with Down syndrome are living successful, fulfilling lives. Unlike the common belief, people with Down syndrome can receive therapy that, depending on the severity, allows them to be more independent and partake in activities that they otherwise may not have been able to. Advances in healthcare are allowing people with Down syndrome to live longer, and now more and more progress is being made towards national awareness.

http://www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/http://www.cdc.gov/ncbddd/birthdefects/downsyndrome/data.htmlhttp://www.globaldownsyndrome.org/about-down-syndrome/misconceptions-vs-reality/http://liveactionnews.org/9-successful-people-with-down-syndrome-who-prove-life-is-worth-living/http://www.thearc.org/learn-about/down-syndrome

Save the Ta-Tas? Save the women!

Elizabeth Kovacs, junior

As the month of October nears its end, I think all of us can agree that it was not lacking in enthusiasm as the month dedicated to raising awareness for breast cancer. While I adore the outpouring of support that breast cancer awareness has generated, there is one thing I believe we could all do without. The phrase “save the ta-tas” is one that most have heard countless times, especially during the month of October. While the expression may seem cute and harmless, it is really just as frivolous and uncultivated as it sounds.

Not only does the phrase focus on a hyper-sexualized attribute of a woman, it implies that saving these body parts is more important than saving the life of the person afflicted with abreastcancer life-altering, potentially fatal illness. Even worse, it implies that women who have undergone life-saving mastectomies to either prevent or treat their cancer are in some way wrong or less feminine than those who have not. Having breasts is not an indicator of femininity or beauty, and cancer patients should not be made to feel so. It’s also discriminatory against the men who suffer from breast cancer.

There is no other cancer that has generated a phrase of the same nature. Saying “save the colon!” or “save the prostate!” sounds pretty ridiculous, and for good reason. Unfortunately, because of the culture we live in where women’s breasts are hyper-sexualized, the focus is taken off of the individual and placed on the body part afflicted. Doing so diminishes the struggle of the cancer patient; of going through chemotherapy and radiation, of making life-changing medical decisions, and the prospect of succumbing to a horrendous disease that has been made into a cutesy slogan.

As soon-to-be nurses, I encourage everyone, especially during the month of October, to remember that our goal is to save the lives of the women (and men) afflicted with breast cancer. Our job as nurses is to support and assist our patients, whether this means “saving their ta-tas” or not. Nurses should know better than anyone else that a disease as serious as cancer should never be reduced to a mere sexist slogan, and that our goal is always to save our patients before anything or anyone else.