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Tip of the Week — Special Interview Segment on a Career in Poison Control Nursing

Maryland Poison Center site

Discover Nursing Site on Poison Control Nursing (many links and resources)

American Association of Poison Control Centers

See Also - these poisoning and overdose segments on the Nursing Show:

Insecticide Poisonings

Household Cleaner Poisonings

Dextromethorphan OD

Snakebites and Venom (pt 1)

Snakebites (pt 2)

Buprenorphine OD

Phenytoin OD (Dilantin)

Poison Control Centers

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Stay informed as a nurse:

Subscribe to American Journal of Nursing via Amazon.com here

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Other Podcasts from Jamie Davis:

• The MedicCast (for EMTs, Paramedics, EMS field work)
• MedicCast News (Weekly short medical news program)
• MedicCast Live (Monthly live call-in show with a single EMS topic)
  
• Headliner News Roundup (Weekly single new item with facts and commentary)
  

Contact Me!

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Music from the Podsafe Music Network by Carrie Cunningham — “Smile Again”

Click here to get other Songs from the MedicCast at the iTunes Store.

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This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

It must be pain management week here at the Nursing Show. After last week’s episode of the Nursing Show, I found this press release from a new resource for nurses and other health professionals.

The results of the survey in the article underlines the need to improve our communication skills, learn to ignore our own preconceptions about pain, and focus not just on hearing the words spoken by our patients but truly listening to the context and meaning.

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Nashville, TN (Sept 8, 2008) - A nationwide survey found a sizable gap exists between patients and healthcare professionals when it comes to understanding and discussing pain. To address this discrepancy, a new coalition of leading pain management organizations has formed to improve how patients and healthcare professionals communicate with each other.

The Let’s Talk Pain Coalition is the first of its kind to unite the perspectives of patients, caregivers, and healthcare professionals to encourage people to talk more about pain, listen actively, and act in ways that improve care for the millions of people who live with pain. The organizations behind Let’s Talk Pain have created a new interactive Web site, www.letstalkpain.org, to provide visitors with comprehensive information and tools to help enhance the dialogue between those affected by pain and healthcare professionals.

“Pain is one of the nation’s leading public health problems, and it often goes under-treated. It is difficult to diagnose and challenging to talk about,” said Dr. Scott Fishman, Chair and President of the American Pain Foundation and Chief of the Division of Pain Medicine and Professor of Anesthesiology at the University of California at Davis. “Open lines of communication and strong patient-professional relationships are what healthcare professionals strive for, and in pain management this is absolutely vital. This Coalition is exciting because it aims to help professionals and patients communicate better in order to help improve pain management.”

The Let’s Talk Pain Coalition debuts this week at the American Academy of Pain Management (the Academy) annual meeting in Nashville, TN. The Academy is one of the founding members of the Coalition along with the American Society for Pain Management Nursing (ASPMN) and the Coalition’s lead organization, the American Pain Foundation (APF). PriCara™, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. is the sponsor of the Coalition.

One of the Coalition’s first activities was a national online survey of pain patients and physicians. It revealed the need for an increase in open and direct conversations about pain and highlighted the impact pain has on patients’ quality of life. The findings also underscored a disconnect between how patients and physicians are communicating with each other. Additional barriers such as lack of trust and not enough time for office visits can affect communications, and ultimately may influence pain management. According to the survey:

• Sixty percent of patients strongly agreed that they can be open and honest about their pain with their physician. Yet, the same survey found that less than 10 percent of physicians strongly agreed that their patients tell them the truth about their pain.
• While the majority of physicians, 97 percent, strongly agreed that there is enough time to discuss pain with their patients, less than half of patients surveyed, 46 percent, felt the same way.
• Pain has a substantial impact on the lives of patients and interferes with their ability to work outside the home and to exercise.
• Treatment-related side effects can have a negative impact on the management of pain, causing some patients and physicians to discontinue using pain medicine.

“Having pain is challenging and has significantly affected my daily life, to the point where I have had to stop working,” said Andrea Cooper, a Maryland-based artist who suffers from chronic pain and is featured in a video on the Let’s Talk Pain Web site. “Pain is an invisible condition. I have learned that the best way to improve my health and my treatment outcome is through engaging in an open and personal dialogue with my healthcare professional and connecting with others to talk about pain.”

Andrea’s story and the Let’s Talk Pain Web site were previewed during the ASPMN annual conference in Tucson, AZ, for pain management nurses this past weekend. Several Web features were highlighted, including:

• Talk: an interactive section where visitors-pain patients and healthcare professionals alike-can learn strategies for opening up the lines of communication about pain. Housed here are video success stories from real patients and healthcare professionals as well as an interactive Q&A with pain experts.
• Listen: a clearinghouse of essential, credible information about pain. Here people with pain, healthcare professionals, caregivers, and family members can become familiar with pain terms and conditions as well as learn more about how pain is assessed so that it is easier to start an informed dialogue.
• Act: a section with up-to-date information on how the Coalition is improving communication within the pain community.

“Let’s Talk Pain offers the first pain resource that will effectively equip people to improve how they discuss pain so that the actions taken improve pain outcomes,” said Nancy Eksterowicz, MSN, RN-BC, Department of Anesthesiology Acute Pain Service, University of Virginia Health System, and President-Elect of ASPMN. “The pain community has never had one online location for credible information, nor have we had a place where patients and healthcare professionals can connect to learn from each others’ experiences.”

About the Survey
The Let’s Talk Pain Coalition commissioned a national, Internet-based survey of 500 pain patients and 275 physicians treating pain, including primary care physicians, oncologists, pain specialists, neurologists, rheumatologists, surgeons, and psychiatrists. Analytica International, a research firm based in New York, NY, conducted the survey from April 3 to 11, 2008.

American Pain Foundation
Founded in 1997, the American Pain Foundation (APF) is an independent nonprofit 501(c)3 organization serving people with pain through information, advocacy, and support. APF’s mission is to improve the quality of life of people with pain by raising public awareness, providing practical information, promoting research, and advocating to remove barriers and to increase access to effective pain management. For more information, visit www.painfoundation.org.

American Academy of Pain Management
The American Academy of Pain Management (the Academy) is a nonprofit organization serving a broad range of clinicians who treat people with pain through education, information, and advocacy. Founded in 1988, the Academy has approximately 5,300 members and is the largest interdisciplinary/integrative pain organization in the United States. Visit www.aapainmanage.org for more info.

American Society for Pain Management Nursing
American Society for Pain Management Nursing’s mission is to advance and promote optimal nursing care for people affected by pain by promoting best nursing practice. This is accomplished through education, standards, advocacy, and research. Visit www.aspmn.org.

PriCara™, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
PriCara™, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., is a major health care company in the United States dedicated to the needs of primary care providers who serve a vital role on the frontline of medicine. For more information about the company, please visit www.PriCara.com.

This past week’s episode of the Nursing Show discussed an overview of three key aspects of pediatric pain assessment. In this article, we’ll cover additional pediatric pain management tips for both working nurses and nursing students, measuring pain levels through:

1. Self Measurement (numeric or pictorial scales, verbal description)
2. Behavioral Assessment (facial expression, withdrawal from pain, guarding, agitation)
3. Physiological Assessment (vital signs, diaphoresis)

Let’s go a bit deeper, and look at each of these assessment options in turn along with some links to some additional reference materials and journal articles that might be useful for follow-up reading. Later this week, we’ll follow up with some more information on ways to treat and manage pain in pediatric patients.

Children and Pain

Choose the one thing that makes children fearful of a visit with a medical practitioner and I’d be willing to bet it’s pain. I have no study to back this one up, just personal experience from my own childhood and from my observations as a parent. Knowing this, I still find it hard to believe that some medical professionals are not more proactive in the management of pediatric pain. Some of this is just entrenched medical convention based on previous articles from long ago. A 1968 article on pediatric pain relief actually said:

“Pediatric patients seldom need medications for relief of pain. They tolerate pain well” (Swafford & Allen, 1968, p. 133).

As I child who grew up during that time frame, I’d like to have a few words with Swafford and Allen.

I believe the issue has been some medical professionals don’t take into account the differences in the ways pediatric patients communicate with their surroundings, as well as the dynamics of adult/child relationships. Thankfully, there has been a broad swing away from the earlier conventional wisdom on pediatric pain towards a more balanced and scientific assessment based approach. The understanding that painful experiences from similar stimuli are not universally measurable from individual to individual has changed medicine’s approach to pain management.

Pain is Personal

The concept that we all experience pain differently may be hard to comprehend. Why should an injection hurt me more than you. It is the same needle size and technique, right? Other variables aside, the differences lie in each person’s past experience with pain, socio-cultural differences attitudes towards pain, their anxiety levels and experience dealing with anxiety, as well as their individual genetic wiring for pain. When these aspects are taken into account, the concept of accurate pain assessment may seem impossible.

Remember, though, that pain is personal. Assessment accuracy doesn’t depend on population averages as vital signs do, but on an individual scale that may be broader or narrower for each patient. Managing pain involves working within that patient’s pain scale. The challenge, therefore, is for the medical professional to remain objective and not impose their pain tolerance or lack of tolerance over the patient’s. Simply assessing and recording pain levels consistently, using the same measurement tools will give the providers the information they need to treat the patient.

Children may not be able to understand the source of the pain, may not be able to communicate its level and quality, or respond to adult assessment techniques. Ask any parent: kids are hard to read. The psychological, behavioral, and personality development that changes constantly from birth to early adulthood make all aspects of child assessment difficult and this may be at the heart of the prior standard of care when managing pediatric pain. The goal of medical personnel interacting with pediatric patients should be focused on improving communication of needs either actively or passively through careful observation and interaction.

Self Measurement and Assessment

Self measurement of pain is the method most are familiar with. Having the individual rate their pain on a scale of 1 to 10 achieves the goal of both measuring the pain and allowing the patient’s personal pain experiences and tolerance to be included in the process. In older children, school age and up, the traditional 1 to 10 scale may be enough to get the pain assessment started, accompanied by careful assessment using the other methods mentioned later in this article. Younger children, meaning young school-age down to older toddlers and preschoolers, may not possess the verbal or cognitive skills to use an abstract numerical scale.

A visual measurement scale like the Wong-Baker FACES Pain Rating Scale or the newer Faces Pain Scale-Revised may be used to assist a younger child with self measurement. The choice of scale may not matter as long as the same scale and assessment technique is used consistently for each patient (McCaffrey, 2002). It is also important to follow any self measurement with the use of behavioral and physiological assessment to verify the correct application of the visual measurement tool.

Behavioral Assessment

For younger children and older children or adults who are developmentally pre-verbal communicators, an assessment of behavior in response to potentially painful procedures or stimuli is in order. The FLACC scale offers one technique. The FLACC scale is based on a mnemonic device and is scored in a fashion similar to the APGAR score with each value receiving a score of 0, 1, or 2 based on the response or assessment. FLACC stands for:

• Face - 0 = no expression/smile; 1 = occasional grimace, frown, withdrawn, disinterested; 2 = frequent or constant quivering chin, clenched jaw
• Legs - 0 = normal, relaxed position; 1 = uneasy, restless, tense; 2 = kicking or legs drawn up
• Activity - 0 = lying quietly, normal position, moves easily; 1 = squirming, shifting back and forth, tense; 2 = arched, rigid, jerking
• Cry - 0 = no cry (awake or asleep); 1 = moans or whimpers, occasional complaint; 2 = crying steadily, screams or sobs, frequent complaint
• Consolability - 0 = content and relaxed; 1 = reassured by occasional touch, hug or being talked to, distractable; 2 = difficult to console or sooth

A score of 0 to 10 is the result, with 0 = little to no pain and 10 = high level of pain. According to the University of Michigan’s pediatric pain assessment site, this scale is effective in assisting with the assessment of children ages 3 months to 7 years.

For children younger than 3 months, there are several neonatal assessment scales out there. The Neonatal/Infant Pain Scale (NIPS) is one such tool, another is the Neonatal Pain, Agitation, and Sedation Scale (N-PASS). Both of these tools require the provider to have experience with neonatal assessment in general but use similar behavioral observation approaches as the FLACC scale to assess the child’s level of pain or discomfort.

The UCLA Medical School website offers a look at several adult and pediatric assessment tools here.

Physiological Assessment

This tool is the last tool in the tool box for a reason. Pediatric vital signs are notoriously unreliable markers for tracking early changes in condition. The child’s healthy vascular system and sympathetic response gives them a remarkable ability to compensate for changes wrought by external stimuli such as shock states and pain. The University of Michigan Health System page on pediatric pain management writes:

“Changes in vital signs do not occur with all children who are experiencing severe pain. Do not rely on vital signs to determine the severity of a childs’s pain.”

However, I believe that tracked over time and coupled with the other assessment tools, the use of vital signs as an additional pain indicator is useful. This is supported by the Cleveland Clinic Foundation’s page on pediatric pain as they choose to include physiological assessment as one of the three methods used when assessing pain in children.

Pain should be assessed at least as often as each set of vitals. Looking back at correlations between the findings of other pain assessment tools and concurrent vitals signs may offer additional insight into the patient’s overall pain level. Place that information in the context of your current assessment findings along with reports of previous caregivers to determine pain level.

Conclusions

Pediatric pain assessment requires a toolbox approach. The competent medical professional reaches into the tool box and bring out the tool or tools needed for each child in order to assess the child’s level of pain and to prepare the necessary interventions and medications to manage that pain. Whether those tools include the FLACC scale, the Wong-Baker FACES scale or the Faces Pain Scale - Revised, or the child’s own measurement and description of pain, the caregiver’s understanding and accurate assessment of a child’s pain followed by prompt treatment and follow-up reassessment should be the goal.

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Read the second part of this series on alternative pain management techniques for pediatric patients here at the Nursing Show site, for nurses by nurses.

Also, listen to this episode of the MedicCast EMS podcast on Pediatric Sports Injuries featuring an interview segment with Pediatrician Dr. Mike of the Pediacast podcast.

Written by Jamie Davis, RN, EMT-P, B.A., A.S. Jamie is the host of the popular online radio programs for medical professionals, the MedicCast and the Nursing Show. He is also a nationally recognized speaker on the use of online media and web tools in higher education and a consultant on new media and podcasting for organizations and business. Contact Jamie to comment on this article here.

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References

• Cleveland Clinic Foundation. (2008). Pain in children. Retrieved Sep. 8, 2008, from http://my.clevelandclinic.org/
• Faulds, S., & Moore, J. (2006). UCLA pain assessment tools. Retrieved Sep. 8, 2008, from http://www.anes.ucla.edu/pain/
• Lehr, V. T. & BeVier, P. (2003). Patient-controlled analgesia for the pediatric patient. Orthopaedic Nursing, 22(4), 298-304.
• McCaffrey, M. (2002). Choosing a faces pain scale. Nursing 2002, 32(5), 68.
• Swafford, L. I. & Allen D. (1968). Pain relief in the pediatric patient. Medical Clinics of North America, 52(1), 131-135.
• University of Michigan Health System. (2008). Pediatric pain management staff education. Retrieved Sep. 8, 2008, from http://www.med.umich.edu/pain/pediatric.htm

Photo Credits

• photo 1: U.S. Department of Defense, (1998). Fey, Frank A. Eyes of Fear.
• photo 2: U.S. Department of Defense, (2007). Cacho, Kerryl. U.S. Navy Cmdr. Con Yee Ling performs a check up on a Vietnamese baby.

I posted previously about the Medicast Podcaster’s meetup at the recent New Media Expo in Las Vegas. The meetup was a great opportunity to talk with each other about our podcasts, plan cross promotion ventures, and discuss how we grew our audiences, monetized our shows, and promoted medical podcasting in general.

I forgot that we had taken a few pictures of the event. Here is a group photo of those who attended the meet up. I hope we’ll have a good turnout again next year and add some new faces to the mix, too! From left to right: Richard and Kelly Fujikawa, Jamie Davis, Amy Davis, Matt Gunn, Carina Stanton, David Van Nuys, Shwen Gwee.

(Thanks to the folks from Raw Voice, Inc. for sharing their insights during the meetup and taking this photo for us!)

As the new fall semester starts for thousands of nursing students around the world, many are concerned or anxious about their upcoming clinical rotations. The question is often asked by our student listeners, “How can I make the most of this year’s clinical rotations when I don’t like the specialties covered this semester?”

First of all, no one is expected to enjoy every aspect of the varied career options that comprise the field of nursing. The issue is not that you will enjoy every aspect but that you learn from the experience. Part of what you learn may be that you don’t want to work in pediatrics or psych.

Here are 8 tips to make sure you get the most out of the rotation, ANY ROTATION!

Be willing to work: Come prepared to spend your time working. Despite the time you think you are spending, no nursing student gets enough time in a clinical setting before graduation. That means you must make the most of the time you have. Be prepared when you hit the floor. If offered the opportunity, look over your patient charts beforehand and plan your day.

Keep an open mind: I’ve heard more than one nursing student make a statement like, “I thought I was going to hate this rotation, but now I think I want to be a long term care nurse and work in a nursing home.” I’m serious. A closed mind will be unable to learn anything. Work to remove your preconceived notions and focus on what is going to be positive about each rotation. Take 5 minutes and make a list of the pros if you have to.

Remember the golden rule: You are there to learn, but that doesn’t mean that you can’t be a helping hand to the unit. A little good will goes a long way. If you see someone who needs help with something, lend a hand! This shows a couple of things. First, you have demonstrated that you aren’t afraid of hard work. If you decide you like the working environment, you have put yourself in a position to be hired. Second, what goes around comes around. When you help someone, they will remember to help you. When a nurse has some interesting skill, procedure, or wound come up, they will be open to inviting you to come take a look. Help someone change some sheets and increase your opportunities to learn.

Divide and conquer: Team work with you fellow students is vital to success in nursing school. Working together in study groups, watching out for last minute scheduling changes, and sharing clinical experiences are all tried and true methods for nursing school success. In the clinical setting, you will need your classmates to proofread your nursing notes, patient care reports, and patient goals and interventions. They will also offer you additional learning opportunities by “sharing” their patients and

List your clinical needs: Knowing what you need to learn will help focus your efforts. Make a list of the clinical learning opportunities that you need, either for competencies or for you own satisfaction. If you need more practice placing a foley catheter, add it to your list. If you want to focus on wound care or replacing dressings, add it to the list. Review the list every week and make changes, marking off those items you’ve completed and adding others as they occur to you.

Use the Instructor: Share you successes and failures with your instructor. They are there to help you succeed. Tell them the areas in which you need improvement. They’ll watch the clinical opportunities for the class and be able to steer you towards the opportunities that will help you reach your goals. Also, ask the instructor to tell you where they think you need to improve. Sometimes, even though you have made a list, you miss something, a blind spot in your clinical education. Your instructor can help you identify these blind spots and help you move forward.

Have resources handy: Students need two things every clinical day. First they need a top quality drug guide. I recommend subscribing to an electronic drug guide like the one provided by Lexi-Comp for nurses. They can be updated regularly (much more often than books) and a good one provides all of the information a nurse needs, all carried in a PDA or on a smart phone. The second item needed is a clinical procedure review guide. You will probably already have one that is part of your textbook package. This gives you a resource to look over when you get a patient needing an intervention you haven’t performed before or haven’t performed often. With these two items, you will be ready for anything.

Know your staff: This goes hand in hand with the “golden rule” tip above. Get to know your staff. Not just the nurses but the techs, CNAs, pharmacists, and unit clerks. Nothing happens in a vacuum. A well run nursing unit is a team effort. Learn people’s names, say hi, and be respectful and friendly. This will pay off when you need something for your patient and can’t find the supplies, need an item from the computer, or just need an extra pair of hands to do something.

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Bonus Tip:  Visit the Nursing Show blog often and subscribe to the Nursing Show podcast for tips just for nurses delivered right to your computer!

The Nursing Show, the number one nursing and nursing student podcast, is proud to announce a new sponsorship agreement with Lexi-Comp and their innovative suite of electronic nursing tools. Lexi-Comp is the perfect partnership for us here at the Nursing Show.

As innovators in the marketplace, Lexi-Comp’s Nursing Suite offers a unique package of frequently updated drug and patient care information.  Available for PDAs, smart phones, and via wireless interfaces, the Lexi-Comp suite for nurses and nursing students offers a wide array valuable services to subscribers.

We have been using these nursing tools for almost 6 months and have been very pleased with the quality, thoroughness, and innovative nature of the products. We also found the Lexi-Comp PDA connection and sync tools to be much easier and smoother to use with our palm devices than other nursing suites we have used in the past. This exciting partnership will provide an opportunity for the Nursing Show listeners to find out more about Lexi-Comp’s line of products and where they can go to listen to special listener-only expert advice from Lexi-Comp’s professionals.

Plus, visitors who visit via the Lexi.com/NursingShow link will be able to use a coupon for 10% of their purchase!

Nursing students are returning to school right now and they are scratching their heads and wondering what they can do to improve their study skills, make the most of clinical situations, and prepare for the NCLEX exam at the other end of the tunnel. Many students have found success using resources here at the Nursing Show but there are other excellent resources out there.

A new book written by a Rutgers, State University of New Jersey nursing professor give practical tips to nursing students. Getting the Most from Nursing School: A Guide to Becoming a Nurse by Robert Atkins is now available at Amazon.com.  To quote the author, “The book is aimed at helping students to acquire the knowledge, skills, and attitudes they will need to become clinically competent and caring nurses.”

If you are interested in getting this book, use the link above to go directly to the Amazon.com page and purchase it there.

Over at this week’s MedicCast podcast for EMS providers, we take a look as some of the special considerations in the treatment of geriatric patients. First, a look at geriatric trauma considerations and why special care is needed to ensure that the elderly trauma patient is taken to the most appropriate facility just like younger patients. A recent study by the State of Maryland found that geriatric trauma patients were not being taken to trauma centers as much as younger patients with similar injuries.

The show also includes a look at polypharmacy and how it affects the geriatric population. Polypharmacy is the presence of at least 5 to 7 prescribed medications for a patient.  Each additional med increases the risk for adverse drug interactions, compounded side effects and endangers the patient.  Encourage patients to review their medications at least annually with their physicians.

Any person may experience problems with polypharmacy, but an elderly person will have more issues due to decreased metabolism, reduced renal and hepatic function, and slowed GI clearance and absorption.

Visit the MedicCast Episode show notes pages here.

One question I often receive is about what podcasts I take the time to listen to. It seemed like a good time to pass on to you some of the better medical podcasts out there. If you have been listening to the show for a while or reading the blog here, you might have a good idea of a few of them based on comments and links here at the Nursing Show.

Now for the shows I Recommend (in no particular order):

Johns Hopkins PodMed Medical News Podcast is a standout review of recent medical and health news and research. They do a good job of boiling down the news to the key issues without the news hype and with an understanding of good research.  Hosts Elizabeth Tracey and Dr. Rick Lange give us a look at science based medicine at its best — short, sweet and to the point!

Mitigation Journal Podcast is produced by Rick Russotti and is an outstanding look at some of the key issues surrounding disaster preparedness and planning from the streets all the way up to the major hospital response and beyond. If you wonder how you would respond to a disaster in your region and how your medical response might be affected, the Mitigation Journal podcast is for you.  You should check out Rick’s podcast now!

The Brain Science Podcast with Dr. Ginger Campbell. Ginger Campbell is an ER doc with an interest in what makes our brains tick. She takes that passion and turns it into a very informative program on how our minds work featuring interviews with leading neuro-science experts from around the world. If you’ve ever wondered why you wonder — this podcast is for you!

PediaCast with Dr. Mike is a show on a variety of pediatric issues presented for parents and providers. Mike is a pediatrician with a large practice who shares his views on recent pediatric medicine news and issues, along with a chuckle and a healthy dose of common sense.

Surgery ICU Rounds with Dr. Jeff Guy. Jeff Guy is a former paramedic who is now a surgeon, medical school professor, and a burn doctor at a major U.S. hospital. His program takes a single ICU or critical care topic and reviews the anatomy and physiology, the etiology, and morbitiy and mortality associated with the problem. He also reviews the research surrounding the topic and the changes to current treatment guidelines. Check this one out!

EMS Live podcast is the granddaddy of EMS and medical podcasting. John Bignell looks at a variety of emergency medical topics in this informative and innovative show. Currently on hiatus, you can still find the back episodes at iTunes and I’m assured by John that the EMS Live microphones will be warming up with fresh episodes again soon!

I’ll wrap up by tooting my own horn a bit:

The MedicCast EMS podcast is a show that offers information on general medical treatment for emergency services providers at all levels. The show covers common medical emergencies seen in the field as well as meds and procedure reviews. My first podcast and the longest running regularly produced EMS podcast out there!

The Nursing Show podcast for nurses, nursing students, and nurse educators lives here on the Nursing Show blog. If you stumbled onto this page but haven’t listened to the show, click the play button and decide for yourself.

The MedicCast News podcast is a weekly review of some of the news items that pop up mid-week between my other podcasts. Each show is only 6 minutes long and is a quick look at some interesting medical news for you without taking up too much of your time. This is hosted over at the Podcaster News Network.

In this past week’s podcast I talked about some online resources to check out for child and teen health education. These resources are just the tip of the iceberg. What do you do with the vast amount of information out there?

In this series here on the Nursing Show podcast site, I will point to some recent nursing ideas that will give you some concrete ideas on how to implement some educational interventions to help children and teens to understand their role in making healthy choices in their lives. Today, let’s talk about teens.

Teens are in that stage of their lives where risk taking and independence often go hand in hand. Many may not even realize that their behaviors are a risky as they are and would rein themselves in when given the opportunity and the information to make an informed decision. If they still insist on making risky choices, the health care team needs to provide them with the tools and resources to protect themselves.

For instance, 16 year old Joe wants to ride his ATV after school every day. This is a risky behavior that could result in serious injury. What can Joe do to reduce his risk while riding his ATV?

• Wear a helmet
• Choose a safe riding area
• Attend an ATV safety course
• Make a list of safety rules for himself
• Understand basic maintenance of his ATV
• Refuse to ride with passengers

These are all possibilities. A recent news item from Illinois looks at a flight paramedic there who had seen enough preventable ATV accidents and decided to do something about it. He contacted his local children’s hospital and asked if they would start an initiative to teach ATV safety in the community to teens. The hospital system said yes and a new teen health and safety program was born.

The paramedic and his flight nurse companion will be paid by their employer to travel to local fairs and events to teach about ATV safety. Their goal is to reach 1,000 teens with the message by Fall 2008. The key parts of their message are — wear a helmet and don’t take on passengers.

This is something that can be done in any community. Identify a risky behavior, contact a partner or facility with an interest in that field or population and begin to assemble a program to reach out and provide information to the proposed audience. Contact local celebrities or bands to provide promotional resources or write a song about the issue.

This doesn’t have to be a purely local initiative. *The State of Washington put together a program to educate teens about the dangers inherent in the workplace after they were identified to be more at risk for work-related injuries. Washington collaborated with teachers and accessed publicly available information on injury rates from the federal government. The program was put in place, evaluated, adjusted and re-adjusted based on effectiveness according to teens and teachers. It used videos, games, role-playing, and written materials to achieve a positive result in reducing teen worker injuries.

The lesson here is to not be afraid to think big. The best nursing interventions are often the simplest so don’t try to reinvent the wheel. If you have a program that is successful locally, find out how you can implement the initiative on a larger level.

Act locally, but think globally! It’s true for nursing as well as the environment.
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*Journal Reference:

Linker, D., Miller, M. E., Freeman, K. S., & Burbacher, T. (2005). Health and safety awareness for working teens: developing a successful, statewide program for educating teen workers. Family & Community Health, 28(3), 225-238.

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Good Parenting Resource on Healthy Teens at Amazon.com