Nursing Notes

May 30, 2011

Memorial Day is for remembering the sacrifices–

Let us remember the nurses who gave up their lives for their patients during the various wars we have fought in.

Let us remember the nurses who are currently in harms way to give aid to our men and women fighting in the Middle East.

This holiday is for remembering.  To see more about our nursing veterans click here.  Below are just a very few of these wonderful women to be remembered.



U.S. Army

Lieutenant Colonel Annie Ruth Graham, Chief Nurse at 91st Evacuation Hospital, Tuy Hoa.

Colonel Graham, from Efland, NC, suffered a stroke in August 1968 and was evacuated to Japan where she died four days later. A veteran of both World War II and Korea, she was 52.

To Colonel Graham’s memorial on The Virtual Wall

First Lieutenant Sharon Ann Lane

1LT Sharon Lane

Lieutenant Lane died from shrapnel wounds when the 312th Evacuation Hospital at Chu Lai was hit by rockets on June 8, 1969. From Canton, OH, she was a month short of her 26th birthday. She was posthumously awarded the Vietnamese Gallantry Cross with Palm and the Bronze Star for Heroism. In 1970, the recovery room at Fitzsimmons Army Hospital in Denver, where Lt. Lane had been assigned before going to Vietnam, was dedicated in her honor. In 1973, Aultman Hospital in Canton, OH, where Lane had attended nursing school, erected a bronze statue of Lane. The names of 110 local servicemen killed in Vietnam are on the base of the statue.

To Lieutenant Lane’s memorial on The Virtual Wall


Second Lieutenant Carol Ann Elizabeth Drazba
Second Lieutenant Elizabeth Ann Jones

1LT Elizabeth Jones

Lieutenant Drazba and Lieutenant Jones were assigned to the 3rd Field Hospital in Saigon. They died in a helicopter crash near Saigon, February 18, 1966. Drazba was from Dunmore, PA., Jones from Allendale, SC. Both were 22 years old.

Lieutenant Jones is pictured here.

To Lieutenant Jones’s memorial page on The Virtual Wall

To Lieutenant Drazba’s memorial page on The Virtual Wall


Captain Eleanor Grace Alexander

CPT Eleanor Alexander

Captain Alexander of Westwood, NJ and Lieutenant Orlowski of Detroit, MI died November 30, 1967. Alexander, stationed at the 85th Evacuation Hospital and Orlowski, stationed at the 67th Evacuation Hospital, in Qui Nhon, had been sent to a hospital in Pleiku to help out during a push. With them when their plane crashed on the return trip to Qui Nhon were two other nurses, Jerome E. Olmstead of Clintonville, WI and Kenneth R. Shoemaker, Jr. of Owensboro, KY. Alexander was 27, Orlowski 23. Both were posthumously awarded Bronze Stars.

To Captain Alexander’s memorial on The Virtual Wall


First Lieutenant Hedwig Diane Orlowski

1LT Hedwig Diane Orlowski

Captain Alexander of Westwood, NJ and Lieutenant Orlowski of Detroit, MI died November 30, 1967. Alexander, stationed at the 85th Evacuation Hospital and Orlowski, stationed at the 67th Evacuation Hospital, in Qui Nhon, had been sent to a hospital in Pleiku to help out during a push. With them when their plane crashed on the return trip to Qui Nhon were two other nurses, Jerome E. Olmstead of Clintonville, WI and Kenneth R. Shoemaker, Jr. of Owensboro, KY. Alexander was 27, Orlowski 23. Both were posthumously awarded Bronze Stars.

To LT “Heddi” Orlowski’s memorial on The Virtual Wall


Second Lieutenant Pamela Dorothy Donovan

1LT Pamela Donovan

Lieutenant Donovan, from Allston, MA, became seriously ill and died on July 8, 1968. She was assigned to the 85th Evacuation Hospital in Qui Nhon. She was 26 years old.

To Lieutenant Donovan’s memorial on The Virtual Wall



U.S. Air Force

Captain Mary Therese Klinker

Captain Klinker, a flight nurse assigned to Clark Air Base in the Philippines, was on the C-5A Galaxy which crashed on April 4 outside Saigon while evacuating Vietnamese orphans. This is known as the Operation Babylift crash. There are also US Air Force and Air Force Association web pages about Operation Babylift. From Lafayette, IN, she was 27. She was posthumously awarded the Airman’s Medal for Heroism and the Meritorious Service Medal.


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May 26, 2011

Fighting America’s ‘Other Drug Problem’: Researchers Find Key to Combating Medication Non-Adherence

Conversation between doctor and patient/consumer.

Image via Wikipedia

As a psychiatric nurse, I am quite familiar with the incidence of non-compliance with prescribed medication.  My patients don’t want to take the medications and don’t believe they need them.  Trying to convince them to follow the medication regime is the hardest part of treatment.

I had not really thought about the incidence of med non-compliance with medical patients, but I guess I should have.  When the body is ill, the mind is not operating at optimal levels due to stress.  I also adhere to the concept that all medical patients have a psychological component that should be treated at the same time.

Here is an article that discusses the ways that nurses can deal with this issue.  I like this article because it shows the nurse as the pivotal point in solving the problem.  Please read this article and while you are there, read some of the other articles on this topic.  This site, Science Daily, is one of my favorite sites online.  I hope you enjoy reading there, too.


ScienceDaily (Nov. 18, 2010)

Medications do not have a chance to fight health problems if they are taken improperly or not taken at all. Non-adherence to medications costs thousands of lives and billions of dollars each year in the United States alone, according to the New England Healthcare Institute. Now, researchers at the University of Missouri have developed an intervention strategy that is three times more effective than previously studied techniques at improving adherence in patients.

Cynthia Russell, associate professor in the MU Sinclair School of Nursing, found that patients who used a Continuous Self-Improvement strategy drastically improved their medication adherence. The strategy focuses on counseling patients to understand how taking medications can fit into their daily routines. Nurses meet with patients and discuss their daily schedules to identify optimal times to take medications and safe places to store their medications.

“Continuous Self-Improvement is a personalized strategy, and the scheduling is different for every patient,” Russell said. “Finding the right place and time for patients to take medications can be as simple as storing the pill bottles in their cars so their medication will be available for them to take during the morning commute to work.”

In the study, kidney transplant patients were given pill bottles with caps that automatically recorded the date and time whenever they were opened. Each month, a nurse reviewed the results in illustrated reports with the patients and discussed how they could improve their adherence. The researchers found significant improvements among patients’ adherence rates. The results indicate the technique is three times more effective than previously studied techniques.

Russell recommends that patients meet with nurses to implement the strategy a few months after medical procedures, when they have returned to their normal routines. During…[read more]

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May 17, 2011

Health Coaching

Here is a wonderful article that showcases Health Coaching in a very positive light and show the benefit our patients get from such a great program, when it is available.  Health Coaching goes hand-in-hand with the work that nurses at the bedside do.  We do education and review of behaviors, the health coach makes a game plan with our patients and follows up with them to encourage participation.

With all the focus on healthcare changes right now, it is very uplifting to find such a wonderful article about this new profession.  I firmly believe that health coaching is here to stay and we need to figure out how to integrate this activity into our patient care.

This article is from Hospital and Health Networks Magazine.  This magazine is full of timely and useful information about all the changes taking place in the healthcare field today.  I recommend you visit the site and spend some time reading there.

Let me know what you think about this article and about health coaching, won’t you?

By Tracy Granzyk Wetzel

Hospitals update their playbooks to make patients active members of the care team

Clint Coon is a computer network manager for the Iowa Department of Safety, still working full time at 66 years of age while managing health conditions affecting his heart, kidneys, vasculature and sleep—in addition to cancer.

Achieving effective communication between two specialty groups is an accomplishment; managing five at once is nearly miraculous. But Coon has a partner on the inside—Dave Swieskowski, M.D., CEO of Mercy Clinics in Des Moines. Swieskowski is a data hound who believes that systems must be redesigned to better harness technology developed over the last 50 years. And he strongly believes patients must be more involved in their own care.

Engaging patients at Mercy Clinics is now part of daily operating procedure. At the forefront is their physician office-based health coach program, which allows Mercy to proactively manage the blood pressure, glucose levels and immunization rates of more than 25,000 patients.

“Any clinical goal we set, we can hit pretty easily,” Swieskowski says. “Cholesterol, cancer screening—it’s all the same process. Any type of follow-up that needs to be done, we think we can get 95 to 97 percent of patients to do so.”

Mercy has been tracking patient outcomes for about 15 years, and success is equal parts patient and provider effort. Through the health coach and shared decision-making programs, patients are trained to become active participants in their care. Health coaches ask patients to set health behavior goals versus outcome goals, and together, coach and patient develop a behavior-change plan with one- to two-week follow-up compared with the typical three months.

“You have to know your patients, track them and measure what is going on with them,” Swieskowski says.

The majority of Coon’s health care takes place at Family Medicine in Urbandale, Iowa. After discharge from a recent hospital stay, Coon’s first stop was the clinic. He walked in without an appointment, and within minutes was in his coach’s office, filling in gaps of information not yet received from the hospital.

“This kind of relationship is greatly appreciated—this go-between, or breaking down of the extended time you can’t reach a doctor,” he says. “I think patients are more comfortable because they get a fairly rapid response.”

Health & Human Services has made patient engagement a priority. In March, Secretary Kathleen Sebelius released the National Strategy for Quality Improvement in Health Care. The strategy, mandated by the Affordable Care Act, defines three broad aims and six national priorities, including “Ensuring that each person and family are engaged partners in their care.”

The pressure to reduce avoidable readmissions underscores the need to engage patients better. In an April 2, 2009, New England Journal of Medicine article, Stephen Jencks, M.D., reported that 50.2 percent of Medicare beneficiaries readmitted within 30 days had not seen a physician between discharge and readmission.

Though many readmissions are planned, experts say some could be avoided partly by helping patients understand their conditions and what they need to do once they’re out of the hospital, and then to stay in contact with them to make sure they are following through.

“The best organizations will thrive in new ways when thinking differently about engaging patients,” Institute for Healthcare Improvement President and CEO Maureen Bisognano said at the American College of Healthcare Executives national conference in March. “We need to understand the entire journey of our patients.”

‘Not Just the Medical Stuff’

Health systems in search of excellence, like Mercy Clinics, are leading the way in coordinating care for their patients and engaging them in the process.

Steven Counsell, professor of medicine at Indiana University and a scientist at the Center for Aging Research, designed the Geriatric Resources for Assessment and Care of Elders program, first implemented at Wishard Health Services in Indianapolis. The GRACE program uses a team approach combining transitional and primary care via home visits, and engaging patients in a care plan individualized to their needs. A social worker and nurse practitioner perform an in-home assessment of patients; collaborate with the GRACE team, which includes a geriatrician, pharmacist and mental-health case manager; and remain the link between patient and primary care physician. Weekly team conferences keep everyone on target.

“It’s not just the medical stuff,” Counsell says. “You can have a great plan for heart failure, correct…[read more]

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May 13, 2011

Happy Nurses Appreciation Week!

Filed under: Nursing — Shirley @ 4:38 pm
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