Jayla

I'm not a big daytime tv person, so I don't have a strong opinion about Oprah either way. The other day I happened to be watching her show, and she made a comment about HTN in African Americans that I have some issue with. She said HTN is so prevalent in the AA community because those that live today are the descendants of Africans that were able to "retain salt and therefore water, so survived on the slave ships" when they were being brought to the Americas. While this seems plausible to a certain degree, I think it negates a number of factors: rampant poverty in AA community (inability to afford healthy food like produce); lack of availability (in any given inner city neighborhood, where many AAs live, there are more fast food joints and fewer grocery stores with adequate healthy food selections); and most importantly, personal accountability. People choose to eat processed food high in salt and saturated fat content, and what this calls for is EDUCATION. Not to mention most AA are not only descended from Africans, but a mix of European, Native American and Latin American. In addition, many AA girls/women don't see themselves as fat when they really are overweight or obese. It's culturally acceptable, even desirable, to be overweight. While we don't want the opposite extreme (anorexia), we need to discourage extremes in either direction. I feel like Oprah, and her "expert" physician, did a disservice to the AA community by making this comment without qualification. It leaves the average person thinking that their high blood pressure is out of their control, and therefore inevitable. What Americans (not just AA) as a whole need more of is a good dose of personal accountability for their own health. I'll get off my soapbox--that was just really bugging me!

I just want to be clear--I do support a cure for every type of cancer. Of course, I do not want anyone to have to go through what my family is going through. My point, however, is that many people view those with a diagnosis of lung cancer as somehow deserving of their disease. Whether this is a subconscious or conscious feeling I cannot say. I am simply trying to bring awareness to this and asking for some sensitivity when dealing with those afflicted by lung cancer and those who love them. No where have I stated that more effort should be put into finding a cure for lung cancer over other types of cancer. I'm happy for you that your grandfather is cancer free.

Thank you! Also, for everyone's information: Radon is considered to be the second leading cause of lung cancer in the U.S. today. Radon gas can come up through the soil under a home or building and enter through gaps and cracks in the foundation or insulation, as well as through pipes, drains, walls or other openings. Radon causes between 15,000 and 22,000 lung cancer deaths each year in the United States -- 12 percent of all lung cancer deaths are linked to radon. Radon problems have been found in every state. The EPA estimates that nearly 1 out of every 15 homes in the U.S. has indoor radon levels at or above the level at which homeowners should take action -- 4 picocuries per liter of air (pCi/L) on a yearly average. Radon can be a problem in schools and workplaces, too. Source: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35427

No, I absolutely do not think it is intentionally said to be hurtful or insensitive. I agree with the above posts. From someone who is personally dealing with this disease: just because such a comment is not meant to be hurtful, doesn't mean it isn't. And it doesn't change the fact that there is a great deal of stigma that goes along with a diagnosis of lung cancer. Consider the fact that there is so much publicity put into finding a cure for breast cancer. Well, the truth is that more women in this country will unfortunately die of lung cancer. I just feel we need to be more cognizant of the stigma associated with this disease.

Given all the recent media attention to cancer, I have been thinking about my recent and personal experience with this disease. In November 2005 my father was diagnosed with stage IV lung cancer. Since that time, I cannot tell you how many people have asked me, "Was your father a smoker?" In my opinion, this is irrelevant. One would not ask a person with HIV/AIDS, "were you really promiscuous?" or "did you abuse IV drugs?" Why? Because the cause of the disease does not lessen it's horrific impact on the person diagnosed or those who love them. To ask this would be considered extremely insensitive. There is such stigma associated with lung cancer, and the fact is, lung cancer is the leading cancer killer of both men and women (taken from the American Lung Association website: http://www.lungusa.org). All I ask is, when dealing with people effected by this disease, please be sensitive to the impact it has on them and those who hold them close. Just as no one deserves to die of breast or colon cancer, no one deserves to die of lung cancer.

Thank you so much for your response--definitely food for thought. I would imagine it would be hard to find a job on a more specialized unit with no cardiac nursing experience, though. I'm not opposed to having M/S patients; I just don't want to end up on such a dysfunctional unit again. But I suppose that can happen no matter what area of nursing you are working in. How much training could I expect as a new nurse on a tele unit? Would I be trained in reading EKG strips and ACLS?

I'm looking to switch into a field of nursing that would both broaden my skill set and provide a challenge. Up till now, my focus has been community/public health nursing. I'm not feeling challenged and after looking around I have noticed a lot of telemetry positions available in my area. What I'm wondering is--are these positions pretty different from general med/surg? I worked med/surg for a few months after graduating and had the worst experience ever! Granted, the culture of the unit/hospital really stunk and I realize not all do. It made me a little gun shy of the whole hospital setting. But, now I think I'm ready to give it a shot again and am wondering what cardiac nursing is like and if you're happy as a nurse in such a position. Thanks a million!

Yep, went back to school in 2000 after graduating with a degree in Anthroplogy in 1998. I took all my prerequisites part time (2/semester) at a CC while working full time at a hospital as a CNA. The job had tuition reimbursement, so I had no loans from any of my prereqs. It took me two years. Started nursing school full time in 2002.

The problem I see is that several of the young girls/women who have requested plan B repeatedly also come in for STD testing very frequently. Many times they are positive for Gonorrhea or Chlamydia, sometime herpes and syphilis. So, what I worry about is unsafe sex with multiple partners and the spread of disease, esp those without a cure. I'm glad plan b is available but hope there is not a correlation of increased spread of STDs.

So why oh why would someone say that they would only want to be attended by a midwife who has nursing training? I know i have little or no understanding of systems outside the UK, but please, give specialist midwives a chance, after all thats what they are, specialists.[/quote Here in the US, unlike most if not all of Europe, most pregnant women are managed by physicians (mainly OB/GYN). However, most people I've talked to who are open to midwifery seem to prefer a CNM. Most CNM programs (not all however) require at least a year of L&D or NICU nursing experience in addition to the midwifery training. I personally would prefer the person who delivers my baby to have experience working in an acute setting. Not all deliveries go smoothly or are without complications (some of which are extremely life threatening)--so while I do believe that pregnancy and birth are natural and not "medical" events, there is no guarantee that they will not become medical events. My personal comfort would be to have a practitioner who has a experience working not only with uncomplicated, straight forward deliveries, but also deliveries where mom and/or baby's health go south and sometimes very quickly. Perhaps training in Europe is different than the US, but I don't feel that lay midwives have the same level of training/experience as a CNM. Just my opinion.

Hello all! Thanks for all the responses! I feel like I've gleaned a lot from reading these posts, considering I have yet to experience labor myself. I did not intend for this to turn into a debate about which is better--natural vs. medicated. I believe every labor experience is different, as is every pregnancy, and every woman and her response to pain. I think it will be interesting to see if the pendulum swings back in the other direction and we once again begin to see more women choosing "natural" over an epidural--these things seem to go in cycles. However, I wish every woman a beautiful labor and birth experience. Thanks again for all the feedback.

Thanks for the replies! I think it's great that there is such support for midwifery--I guess I'm not surprised though. I'm glad to hear no one's had a bad experience with a midwife. This is pretty much the response I thought I'd get, but was just curious. Of course, there are situations in which an MD/DO would be required, but for low risk pregnancies, I fully support midwife care. Interesting to learn that a DO has the same scope of practice as an MD. I have yet to work with a DO, so I wasn't sure.

As a nurse, particularly an ER nurse, you assume the responsibility of saving the lives of people who take risks you may be against--every day. For example, you might be morally against IV drug use, but if a patient is brought through the doors comatose d/t heroine overdose, do you refuse to administer narcan? That would be construed as negligence and/or abandonment. As a previous poster mentioned, if this woman was bleeding out d/t a spontaneous abortion there would be no debate. Regardless of the cause of an emergency situation, in the case of imminent death, failure to provide any and all life saving measures is negligent. Unless, of course, the patient is DNR status.

For those of you who work with pregnant/laboring women: for a normal, low risk pregnancy, which type of provider do you think is best? Either for you, personally, or your patients? I have not had a baby yet, but my preference would be a nurse midwife. My reasons: a delivery done by a nurse midwife is significantly less costly than an MD Nurse Midwives generally seem to view labor as a more natural process requiring less medical intervention a nurse midwive's approach to pregnancy is more holisticI would not choose a midwife who did not have a nursing background. What would make you choose one over the other? Sorry, I haven't included DO since I don't know whether or not L&D was within their scope of practice...

A very comprehensive book about providing health care to latino patients is called, well, The Latino Patient (Nilda Chong). It discusses many cultural aspects of providing health care to people from central and south america. Of course, it only pertains to those specific cultures.