Think different

March 2009 -- This month we found an unusually high number of press articles from the U.S. and U.K. highlighting nurse-led innovations in health care. A March 1 Birmingham News (AL) story by Anna Velasco profiles a nurse who has founded and managed a health clinic for the homeless under an interstate highway bridge. A March 21 BBC News article by Jane Elliott describes the achievements of a pioneering nurse researcher who showed how to treat deadly bedsores in the 1950's. A March 23 article by Chris Segal in the Panama City News Herald (FL) reports that a local nurse appears on national television annually to raise awareness of the dangers posed by Spring Break, especially those associated with alcohol abuse. And Dee Adcock's March 24 report in the Dorset Echo (U.K.) discusses the work of a group of nursing students to raise awareness of post-natal depression. Some of these pieces are brief, and some have minor problems, but all convey that nurses are critical thinkers who create and implement new care systems that improve patient outcomes. We salute those responsible for the articles.

Birmingham News (AL) story by Anna Velasco, March 1

BBC News article by Jane Elliott, March 21

Panama City News Herald article by Chris Segal, March 23

Dorset Echo (U.K.) article by Dee Adcock, March 24

 
Birmingham News (AL) story by Anna Velasco, March 1

Anna Velasco's March 1 Birmingham News article was headlined "Nurse runs medical clinic for homeless under Birmingham, Alabama bridge." The generally good piece reports that two and a half years ago, St. Vincent's East Hospital OR nurse Cindy Underwood started a free clinic that provides care to homeless people once a month under an interstate highway bridge. The clinic grew out of Underwood's work serving food at that location as part of a church outreach program. Today, the volunteer clinic "has grown to an operation that as many as 80 homeless people flock to for antibiotics, blood pressure medicine and medical attention." Underwood was named one of 10 "health care heroes" of 2009 by the Alabama Hospital Association for her role in the program. The clinic is part of The Nest, a nonprofit supported by many local churches that feeds the homeless in the city.

The Birmingham News piece includes quotes from Underwood, and from two physicians she recruited from St. Vincent's East. But it does not name or quote any of the other nurses who volunteer. The report focuses on the value of the care the physicians provide, such as prescribing blood pressure medication and antibiotics for serious infections, and sewing up wounds. But it merely says that the other nurse volunteers "help with the screenings," failing to explain the nursing role in detecting and treating serious conditions. So it could be taken to suggest that physician care is what makes the clinic important. The piece does make clear the Underwood runs the clinic, struggling all month to obtain medications and supplies. The report also notes that the clinic tries to connect patients with available services, to encourage more long-term solutions to their problems. And while Underwood's clinic work is driven by her faith ("It's just a thing God laid on my heart"), there is no suggestion that she imposes her religious beliefs on patients.

See Anna Velasco's March 1 Birmingham News article "Nurse runs medical clinic for homeless under Birmingham, Alabama bridge."

You can write to the author at avelasco@bhamnews.com.

 
BBC News article by Jane Elliott, March 21

Jane Elliott's March 21 BBC News article, "How one nurse helped stop killer bedsores," describes the important achievements of nurse Doreen Norton, whose 1950's research showed that the best way to treat deadly bedsores was simply to relieve the skin pressure that is the primary cause. The piece says Norton's work is just one example of the innovative achievements of nurses, whose work over the last 50 years was then being honored by the Royal College of Nursing at its annual research conference in Cardiff, Wales. The piece quotes Martin Johnson, a nursing professor at the University of Salford:

If one had a bedsore on the sacrum (at the base of the spine) or the heel, there were about 150 different prescriptions that ward sisters would issue to remedy this. None of these were very successful. She was able to show that really the only successful way of treating pressure sores was to remove the pressure - really obvious! This had an immediate implication that the nurses had to turn the patients at least every two hours. And this was a study that was based on science rather than just what people thought.

Kate Gerrish, a nursing professor at Sheffield City Hospitals and Sheffield Hallam University, adds that

looking back, what we did was horrifying. ... When we were trying to prevent pressure sores we would put all sorts of things on their skin - including mentholated spirits and soap, and we would massage the areas. All that has been proved to be detrimental to patients.

Norton, who had mechanical skills, also designed the "King's Fund bed," an adjustable bed used in many hospitals.

The short BBC piece simply lets current nursing scholars explain the life-saving achievement of a nursing leader from a half century ago. The report is particularly commendable in that the reporter chose to focus on bedsores, whose importance is not well understood, as reflected in the dismissive way in which they have been addressed in Hollywood hospital shows, on the rare occasions when they has been mentioned at all (as in a 2007 episode of Grey's Anatomy).

See Jane Elliott's March 21 article "How one nurse helped stop killer bedsores" in the BBC News.

 
Panama City News Herald article by Chris Segal, March 23

Chris Segal's March 23 article in the Panama City News Herald is "Local nurse to talk Spring Break Safety on national TV." Carole Taipalus is a veteran ED nurse and sexual assault examiner at Gulf Coast Medical Center who has appeared for the last two years on "The Morning Show with Mike and Juliet," a Fox News-syndicated television show, to publicize "the potential dangers of Spring Break." The short piece seems to be based entirely on input from Taipalus herself. She speaks of trying to raise awareness about these dangers, particularly assaults and other injuries association with alcohol:

"We see a lot of alcohol overdoses," she said. "We have a lot of things because these people are totally wasted." She once saw a patient in the emergency room with a huge gash in his head from playing football in his hotel room with an iron. The number one thing breakers can do to help keep them safe is to stay in a group and never walk off with a stranger, she said.

The piece notes that only an estimated 3% of sexual assaults are reported; Taipalus says that fear and shame are factors. And the item reports that this year, Taipalus will be "recording the data of how many spring breakers come into the hospital with assault-related complications." It might have explained why she is doing that, e.g., whether she is conducting a formal study, and how that data might be used to improve health. But on the whole, the piece is a good quick look at one nurse's innovative public health work.

See Chris Segal's March 23 article in the Panama City News Herald  "Local nurse to talk Spring Break Safety on national TV."

You can write to the author at csegal@pcnh.com.

 
Dorset Echo (U.K.) article by Dee Adcock, March 24

Dee Adcock's March 24 Dorset Echo story is "Dorchester nurses campaign to help new mums." It describes a group of "six nurses" who are "urging new mums who are suffering from post-natal depression to come and talk to them...campaigning to raise the awareness of the condition that afflicts one in eight women after the birth of a baby." At other times, the piece describes some of the six as "student nurses" with different areas of focus, including midwifery, pediatrics, and learning disabilities, and it says that the six are "all in a final year of study through Bournemouth University." So it is not clear (at least to us) whether they are actually undergraduate nursing students, or qualified nurses who are pursuing advanced degrees or certifications. Nursing students are not "nurses" any more than medical students are "physicians."

In any case, the Dorset Echo piece provides a very good look at those with different nursing specialties working together to encourage discussion of a health problem that is "still seen as a taboo subject that cast[s] a shadow over the joy of a new baby." In fact, the taboo aspect is what appears to have drawn the nurses/students, who focused on it "as part of their studies after discovering that many women go undiagnosed or refuse to accept they might have the condition." "Student children's nurse" Kirsty Wright created posters and a "film advertisement" conveying the message "talk about it," to be shown in cinemas and health centers. Wright, who clearly sees the power of the media to affect health matters, also notes that "the TV soaps should carry a good storyline about it - they don't do it very well at the moment." Similarly, "student adult general nurse" Sarah Moreton "praised high profile actresses and personalities who are frank about their own post-natal depression." Stressing that post-natal depression "is treatable, especially by counselling," Moreton observes:

The Government has a major Time To Change campaign running to change the approach to mental illness and that's what we want to achieve with our campaign. Post-natal depression is like cancer was 10 years ago in the way that it's one of those hush-hush topics. A buddy system where mothers help other mothers is most important.

Moreton also says some mothers do not seek treatment for fear of losing their children. (Unfortunately, the article did not mention the important evidence suggesting that DHA supplements decrease post-partum depression.)

The image in the media is that motherhood is supposed to be a glorious time with everything perfect. But it's not like that for many mums.

The report also includes helpful information on post-natal depression from the nurses/students, who distinguish it from the more common "baby blues" most women experience, note that it can affect any mother, and explain that help is available from "the midwife, health visitor or GP and it is worth seeking out any support groups in your area." Lastly, the piece notes that the group's project has not received funding, but urges readers to contact them to learn more or "offer help or funding."

See Dee Adcock's March 24 Dorset Echo "Dorchester nurses campaign to help new mums." You can email the author at dee.adcock@dorsetecho.co.uk. You can contact the post-partum depression group at postnataldepressionletstalkaboutit@live.co.uk.

Innovations summary

We commend those responsible for these reports, which each show the public that nurses have valuable health expertise, and that they can spearhead innovative health measures in a wide variety of areas.