Friday, 24 September 2021

Nurses, Nurse, Nursing Responsibilities, Nursing Career, Nursing Professionals, Nursing Job

My friends are all leaving me, and I don’t blame them. Throughout the past six months, it seems as though every week I walk onto the unit, I hear that another one of my coworkers has put in their two weeks’ notice. The horribly sad part is that it feels like management just sees it as another job posting to start advertising for, but to the staff that has worked alongside them for years, it feels like a moral injury to see their position so easily replaceable. These nurses provide skills and bring character to the unit that no one else can replace, and although new nurses can bring their own gifts and talents, it is devastating seeing your department’s heartbeat start to change. 

Not only are nurses working in a global pandemic pouring everything we have into helping patients, a new pandemic has hit healthcare workers specifically; it’s called burnout. Unfortunately many of the issues that contribute to this burnout have existed for decades, but COVID has multiplied their effects and are pushing nurses to their extreme limits. 

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Nurses constantly mention that the pay rate in relation to the risk remains one of the main reasons that drives them away from the bedside. 

◉ Nurses haven’t received any hazard pay throughout this entire pandemic, and most have not received any raise larger than the expected cost of living increase. 

◉ It feels insulting when hospital management will not offer any retention incentives, but will pay travelers 3 times the hourly wage to do the same job. It’s no wonder so many nurses are leaving their current place of employment and traveling for a short time, but until hospitals can start offering more incentive for nurses to stay, the problem will only continue to escalate. 

Unsurprisingly, however, the most common reason nurses are leaving the bedside is the increased physical, emotional, and mental demands that have occurred within the past year. Regardless of the department, the pandemic has caused a decrease in staff, supplies, and support which has resulted in nurses picking up extra patients, shifts, and responsibilities. Our breaks have been replaced with extra patients, and our empathy has been replaced with exhausted hearts. Just in the past few weeks, I have heard nurses tell me these reasons they find nursing harder than ever.

◉ “The more I’m in the hospital, the more I hate the hospital”

◉ “It is hard to care for patients anymore”

◉ “I just can’t find it in me to care anymore. I try, but I just don’t care.”

◉ “It is just depressing watching people die all the time.”

◉ “I’m now doing three people’s jobs. Shouldn’t I get paid three people’s salaries?”

◉ “My body can’t handle it any more. I need a way out to save my physical body.”

◉ “I am starting to hate human kind.”

Anonymously share your experience working as a nurse right now - take “The State of Nursing” survey. 

Gone are the days of the idyllic images of Florence and nurses walking around with neatly done hair and large smiles while ambulating their patient down the hallway. Now we have images of nurses in space suits with cracked lips due to dehydration, hair in dreads from the three masks that keep rubbing their heads raw, and bags we don’t even get discounts for recycling under our eyes from doing the work of three other people. 

America is about to see a nursing shortage unlike anything else. Unless we see systemic change beyond what we could even imagine, this profession will endure an inevitable change. I do not place any blame on my coworkers who have chosen to pursue a different career, but for those of us that continue to work at the bedside, it often feels like so much effort to remain upbeat and positive about the nature of our profession. 

Read more about the systemic issues causing nurses to leave the profession, click here. 


Wednesday, 22 September 2021

The elderly have been determined to be among those most vulnerable to coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The mortality rate and severity of the disease in this group are reported to be extremely high. In most countries, COVID-19 vaccination has been prioritized for residents and staff of long-term care facilities (LTCFs) and frontline workers. In Norway, residents of LTCFs primarily receive health care at the facility. They are generally not admitted to hospitals except in emergencies.


It is important to understand the vaccine effectiveness (VE) to determine how much protection it offers to the general population. Unfortunately, only a few studies are available that have determined the effect of the COVID-19 vaccine among the residents of LTCFs.

The unique setting in Norway allowed the scientists to study VE among both staff and residents in LTCFs.

Taking this opportunity, researchers focused on estimating the effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 infections among residents and staff of LTCFs. They also analyzed the effect of the vaccine on the rate of hospitalization among staff and deaths among residents.

It must be highlighted that both these factors, i.e., mortality rate and hospitalization represent disease severity. This research, which can act as a guide for COVID-19 vaccination programs, is available on the medRxiv preprint server.

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Effectiveness of COVID-19 vaccines among residents and health care workers in LTCFs

In this study, researchers obtained data from BeredtC19, a preparedness registry containing individual-level data from various Norwegian registries.

They included all health care workers (HCW) who worked at LTCFs in the third week of January 2021 and residents who registered for a long-term stay at an LTCF in 2020.

This study excluded individuals who did not adhere to national recommendations about the interval between the first and second dose of the COVID-19 vaccine.

To avoid biases, individuals who had prior SARS-CoV-2 infection were not considered in this study. Researchers defined the vaccination status as unvaccinated (less than 14 days after the first dose of vaccine), partially vaccinated (14 days or more after the 1st dose and less than six days after the second dose), and fully vaccinated (seven days or more after the second dose).

In the sample considered for this study, 85.4% of LTCF residents and 71.1% of the HCWs received at least one vaccine dose during the follow-up period. The median ages of the residents and HCWs were estimated to be 87 years 39 years, respectively.

Researchers used Cox proportional hazard models to calculate VE in this study cohort, considering the vaccination status and adjusting for the age, sex, and associated underlying health conditions. They estimated the VE against positive SARS-CoV-2 infection to be 81.5% among the fully vaccinated and 40.8% for partly vaccinated residents and HCWs.

Scientists explained that in this study, personal attributes of LTCF residents, such as sex, age, and underlying conditions, had a minimal effect on the estimation result due to the relatively uniform population characteristics.

The Cox proportional hazard models could not estimate the degree of protection that prevailed among partly vaccinated residents, which may be due to rapid vaccination rollout and relatively short intervals between doses, i.e., residents received their second COVID-19 vaccine dose three weeks after the first.

The mortality rate of the resident population owing to COVID-19 disease was high. As a result, researchers estimated the VE in preventing death from COVID-19. They reported that in the fully vaccinated group, the mortality rate was reduced by 93.1%.

After adjusting for the age, sex, and underlying conditions of the HCWs, the VE against positive SARS-CoV-2 infection was estimated to be 45.0% among the partly vaccinated members and 81.4% among fully vaccinated candidates. Previous studies had reported a low mortality rate associated with COVID-19 in the general population of Norway.

Unlike the previous group, hospital admissions were considered to be an indicator of disease severity among HCWs. The current study reported that around 56 HCWs were hospitalized with COVID-19, among which two candidates were partly vaccinated.

None of the fully vaccinated HCW candidates required hospitalization. This study reported VE against COVID-19 hospitalization to be 81.7% for partly vaccinated HCWs in LTCFs.

Interestingly, this study observed that the total protection of unvaccinated residents significantly increased through staff vaccination. Thus, scientists believe that the outcomes of this study could be essential for the management of COVID-19 in LTCFs.


Tuesday, 21 September 2021

Shortly after the mass vaccination program against coronavirus disease 2019 (COVID-19) began in the UK, news outlets began to report severe side effects in a minority of those vaccinated. One of the more serious conditions that occurred is known as cerebral venous thrombosis (CVT) – a blood clot in the brain's venous sinuses that can lead to swelling, hemorrhage and death.

Even more worrying, CVT in those who had recently been vaccinated showed a much higher mortality rate than CVT that had been triggered by alternate sources. Headache is the most common symptom following vaccination, and is also one of the most frequent symptoms of CVT.

Researchers from the Akershus University Hospital in Norway investigated 77 cases of CVT in vaccinated subjects to identify risks and warning signs to better predict these severe side effects. The group's findings can be found in the Journal of Headache and Pain.

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It is worth noting that these symptoms only occurred in a very small minority of individuals, and authorities recommend that everyone eligible to become vaccinated does so.

The researchers searched through PubMed for all case studies and reported cases of CVT, as well as examining reports from the United States Centers for Disease Control and Prevention and the European Medicines Data. They evaluated these gathered cases based on certain variables, including age, sex, use of contraceptives, use of hormone replacement therapy, presence of a headache, presence of additional symptoms, the interval between headache and first symptom, intracranial hemorrhage and death.

For a control group, they used reports of headaches following the vaccines from the United States Vaccine Adverse Event Reporting System. A search of 'headache' against coronavirus vaccines returns over 100,000 results.

To analyze the cases, univariate logistic regression was used, with a standard 0.05% confidence limit. In total, 4.2% of patients suffering CVT were between 60 and 69, 95.8% of patients were below sixty, and 46.5% were below 40. This is supported by previous studies from CVT in non-vaccinated patients, showing that individuals ~30 years old are at most risk. Women were more affected than men, and made up 89.7% of cases. Five patients used contraceptives, and one was receiving estrogen therapy.

It normally took over a week following the vaccination for the first symptom to present – in 50% of cases, this was a headache, with various systemic or neurological symptoms in the other 50%. In ~25% of cases, multiple location thrombosis was recorded. In 24.7% of cases, the patient died. The statistical analysis clearly showed that In patients with CVT, the presence of headache was associated with increased risk of hemorrhage — but not with increased risk of death.

While headache is a very common side effect, in the vast majority of cases, it is resolved harmlessly and quickly. In almost all of the cases of CVT in which the headache was described, the onset was delayed for a week or longer – a rarity in patients that did not suffer CVT. The headaches were also severe, became progressively more so, and did not respond well to treatment.

The authors highlight the value this early warning sign could provide, especially as most cases of CVT are not immediately diagnosed, and delayed treatment reduces patient prognosis significantly. They urge that physicians be informed of this warning sign. Informing recently vaccinated individuals could also increase survival rates – although it may easily increase vaccine hesitancy as well. CVT can be detected with computed tomography, which will could show warning signs such as hyperdense veins or sinus, venous infarcts, edema or intracranial hemorrhage. World Health Organization recommended treatment includes immunoglobulins and non-heparin-based anticoagulants.


Monday, 20 September 2021

Nursing Career, Nursing Responsibilities, Nursing Professionals, Nursing Roles, Nursing Certification

As an ER nurse, I am more nervous than ever for the future of our hospitals. When I say this, I am not referring to the catastrophic outcomes that have devastated so many patients and their family’s lives. I am talking about the abuse this pandemic has beaten down our staff with by hurling unrelenting punches in successive order; and I am worried about how hospitals will respond to this crisis. 

For the first time in my career, I am seeing nurses, doctors, techs, and a myriad of other ancillary staff express an anger towards some of the patient’s we are caring for. There are staff members that are verbalizing frustration and disdain directed at patients as a result of exhaustion. 

Under normal circumstances, many healthcare workers use dark humor and sarcastic banter directed at patients as a coping mechanism. But right now there is no comedic goal woven into the words I am hearing at work. There is anger, frustration, exhaustion, and apathy. My friends around the country are so burnt out; they have lost their desire to pour their hearts into this job because it keeps sucking the life out of them. 

Walking around the hospital hallways, I miss the joy. I miss the spark. I miss seeing my friends come alive after a meaningful patient interaction. I miss feeling supported. I miss the days when we talked about the headlines in one another’s lives instead of the headlines on the news. I miss seeing each other’s smiles. 

Compassion Fatigue

Compassion fatigue, defined as “the physical and mental exhaustion and emotional withdrawal experienced by those that care for sick or traumatized people over an extended period of time,” is slowly killing the future of nursing. Although this has always had disastrous ramifications for any nurse throughout their career, we are seeing unprecedented amounts of nurses fleeing the bedside because they can no longer deal with the secondary trauma related to our work. Understaffed and overworked has just become the new normal. Nurses have been refused vacation time, mandated overtime, forced to care for double the patient load, and required to work on new units. The disruptions in supply chains have made our jobs increasingly more challenging as we have to adapt to new materials and add extra steps to already complicated processes. 

Regardless of an individual’s personal opinion on the vaccine, both sides have felt the shift from being “essential” to being “expendable.” Some nurses feel personally disrespected as unvaccinated patient’s charge into our hospitals demanding that we save their lives. Other nurses fear losing their jobs after loyally serving a given institution for their entire career. The compounded amount of tension on top of an already stressful job has already pushed many nurses away from the bedside and in some hospitals has caused a division among their own staff. 

The REAL Nursing Shortage

The spring and early summer weeks gave us time to imagine what life might be like when this is all over. But, I worry that entering into another round of continually living in “fight or flight” mode in the hospitals will eventually use up all the reserve that some nurses have to give. Hospitals are currently treading water. They are unable to fill their hundreds of open clinical positions, older nurses that remained in the fight to get us through the initial wave are now retiring, new nurses coming into the profession have not been able to receive the same level of experience that they should, and the health of their current staff is declining at the rates COVID is increasing. 

As the months and years ahead begin to unfold, I am confident that the term “nursing shortage” will be thrown around like a football on a beach day. 

Let me be very clear. It is not that there is a shortage of nurses in this country. It is that there is a shortage of facilities that have been able to provide adequate working conditions throughout this pandemic to retain their staff. I fear for the endless ramifications this will have on my future in this profession. 

Read the report on the REAL reasons behind the nursing shortage

But perhaps my greatest fear is this. 

That in a few years when one of your family members is hospitalized, they will be missing out on some of the kindest, most compassionate, gracious, and attentive nurses because this pandemic pushed them away from the bedside. So America, please help do your part to end this. And please, be kind to my friends across the country who continue to show up despite having a tank that is well below empty.


Tuesday, 14 September 2021

NICU Nurses, Nursing, Nurse, Nurse Career, Nurse Manager, Nursing Responsibilities

In honor of NICU Awareness Month, which started in September, the popular baby gear brand  4moms is helping out NICUs across the country by donating nearly $18,000 worth of MamaRoo baby swings to 15 different hospitals. 

The giveaway campaign from 4moms is being done in partnership with Project Sweet Peas, a non-profit that supports NICU families as well as families who have experienced infant loss and The Superhero Project, which raises money for NICUs, donates needed items like gift baskets for parents, and works to place Angel Eyes cameras so families who need to be away from their hospitalized infants can always keep a close eye on their little ones. 

All of the organizations involved are incredible and like any family who has experienced a NICU stay knows, every thoughtful gesture makes an entire world of difference. 

How to Win a MamaRoo for Your NICU Unit

The way the giveaway campaign works is simple: parents, families, or nurses can all nominate any NICU that they think is deserving to win the MamaRoo infant seat donation. In total, 15 hospitals will receive donations of the MamaRoo infant seats. 

4moms has sponsored this giveaway in the past, but this year has expanded its program to donate swings to 5 more hospitals, giving almost $10,000 more in product. Last year’s recipients were:

◉ Ascension Saint Vincent’s Hospital (Birmingham, AL)

◉ Elliot Hospital (Manchester, NH)

◉ Grandview Medical Center (Birmingham, AL)

◉ John Muir Medical Center (Walnut Creek, CA)

◉ Prisma Health Richland (Columbia, SC)

◉ Saint Joseph Hospital (Denver, CO)

◉ University of Maryland Medical Center (College Park, MD)

◉ Valleywise Health (Phoenix, AZ)

◉ Willis Knighton South (Shreveport, LA)

◉ Woman's Hospital (Baton Rouge, LA)

Because 4moms hopes to reach as many hospitals as possible, the 10 recipients from last year aren’t eligible for the gifting this year but can be nominated again in 2022. 

How MamaRoos Benefit NICUs

According to 4moms, the mamaRoo infant seat is instrumental in the NICU, especially because it can be an effective non-pharmacological intervention for babies experiencing symptoms of Neonatal Abstinence Syndrome (NAS). 

A 4moms representative tells that both doctors and nurses have found the natural bouncing and swaying motion of the MamaRoo Infant Seat to be a valuable tool for helping to calm and soothe these fragile patients when their families can't be there.  

If you’re not familiar with the magic that is the mamaRoo, allow us to explain it: unlike traditional baby swings, which only swing back and forth or sometimes, side to side, the mamaRoo is completely different. It doesn’t swing like a traditional baby swing but instead, bounces both up and down and from side-to-side, mimicking the motion of a baby being in a parent or caregiver’s arms.  

If you’ve never noticed how a baby will cry when you’re sitting down, but magically be happy again when you stand up and bounce them, you’ll understand exactly why the mamaRoo infant swing can be so helpful, especially in a NICU setting when babies need a lot of cuddling to thrive. The swing and seat combo provides much-needed movement as an extra “set of hands” for the hardworking and always-busy NICU nurses on the unit. 

Nominate a NICU

If you know of a NICU that you’d like to nominate (including your own, if you’re a NICU nurse!) you can fill out a form on the 4moms website to share about the NICU you’ve nominated and enter them to win. All you need to do to nominate a NICU is share a little bit of information about yourself, the NICU you’re nominating (you’ll need name, city, and zip code) and a 500-word submission about why you’d like 4moms to donate infant swings to that NICU unit. 

The 4moms website explains that the NICUs are chosen based on many different factors, including the submission story itself, how many times the NICU is nominated and if Project Sweet Peas or The Superhero Project are able to deliver in a market. The nomination submission period ends on September 30, 2021, so get out there and start nominating! 

Oh, and one last thing: 4moms also has another way to support NICUs if you’re already a mamaRoo infant swing owner--you can donate your gently used mamaRoo through 4moms partner program, Good Buy Gear, and in return, mamaRoo will donate one new infant seat to a NICU. Pretty cool, right?


Monday, 13 September 2021

There seems to be a tendency to hastily use imperfect and questionable data to train an AI solution for COVID-19, a dangerous trend that not only does not help any patient or physician but also damages the reputation of the AI community. Dealing with a pandemic – as significant as it is – does not suspend basic scientific principles. Data has to be curated by medical experts, and full and rigorous validations have to be performed, and results have to be reviewed by peers before we deploy any solution or even proposal into the world, particularly when the society is dealing with many uncertainties.

COVID-19 AI Research, COVID-19, Artificial Intelligence, Surge of Sensationalist, Coronavirus

It is safe to say that we are all deeply concerned about the COVID-19 pandemic. This coronavirus has drastically changed our reality: stress, restrictions, quarantines, heroic sacrifices of caregivers including staff, nurses and physicians, losing loved ones, economic hardships, and massive uncertainties about what is in store in the coming months. Under such circumstances, it is only natural that many of us are thinking of ways to help - in the fastest ways possible. The AI community is not an exception.

Machine learning methods live from data. They learn from labeled data to classify, predict and estimate. The quality and reliability of any AI method directly depend on the quality and reliability of the labeled data. In computer science, we talk about “garbage in, garbage out” (GIGO) which summarizes the experience that low-quality input data generates unreliable output or “garbage”. This becomes even more critical when we are dealing with highly complex data modalities, such as medical images - data that generally require highly specialized knowledge for correct interpretations.

Within the AI community, we are fully dependent on data. As long as the domain is not sensitive (finance, healthcare, surveillance, etc.), we usually assemble our datasets by using different methods; From the manual gathering of samples up to highly sophisticated crawlers to parse through the Internet and other publicly available repositories. In medical imaging, we deal with a highly sensitive domain in which a long process is generally required to curate and access a set of labeled images. Needless to say, the curation has to happen within the walls of a hospital not just because the experts are there, but also due to the required de-identification of images to comply with privacy regulations.

But, sometimes we get impatient; we create our toy datasets by the manual collection of publicly accessible sources (e.g., online journals) - and there is generally no concern about this approach. Most of the time we – as AI researchers with no clinical or medical competency – create our toy datasets to run initial investigations and get a feeling for the challenges to come. This usually happens in anticipation of receiving a professionally curated dataset, a process that is often slowed down by ethic reviews and intellectual property negotiations.  

To be clear, a “toy dataset” in the medical imaging domain is not a toy just because it is commonly very small, but more importantly because it has been created by engineers and computer scientists, and not by physicians and medical/clinical experts. And, nobody would complain if we play with our toys inside our AI labs to get prepared to deal with the actual data from the hospital.

Radiologists around the world are understandably very busy, to put it mildly; it is not the best time to forge collaborations with radiologists if you are an overambitious AI researcher who wants to help. So, some of us have started to assemble our own dataset to get prepared for future tasks.

Collections of x-ray and partly CT images – scraped from the Internet – seem to emerge here and there and appear to be evolving as the creators continue to add images. Because of the availability of such datasets on one side and the ubiquity of basic AI knowledge and tools on the other side, many AI enthusiasts and start-ups have impulsively begun to develop solutions for COVID-19 in x-ray images. One finds websites and blogs that advise how to detect COVID-19 from x-ray scans with high accuracy. Others provide a sort of tutorial on detecting COVID-19 in X-ray images. We are even starting to see non-peer-reviewed papers that go a step further and baptize their solution with aggrandizing names like “COVID-Net”. This type of works commonly lacks many experimental details to explain how one has dealt with a few images from a very small number of patients to feed the deep network. Such papers report no validation, and no radiologist has guided the experiments. Many of these works were hurriedly made public before the creators of datasets could even provide sufficient explanation about their collection process. In an attempt to overcome the small data size, AI enthusiasts and start-ups mix the few COVID-19 images with other public datasets, i.e., pneumonia datasets. This is generally quite clever but I looked more closely at one case and the trouble is that the pneumonia cases were pediatric images; so the COVID-Nets are comparing pediatric pneumonia (children one to five years old) with adult COVID-19 patients. Well, this happens when we exclude radiologists from research that needs expert oversight.

Why are we rushing to publish faulty AI results on tiny datasets mixed with wrong anatomies, with no radiological backing, and with no validation? Do we want to help COVID-19 patients?

Perhaps the abundance of funding opportunity announcements in recent days, and the possibility of getting exposure for our research is misleading us into faulty research conduct; we cannot abandon fundamental scientific principles due to lockdowns and quarantines. AI is neither a ventilator nor a vaccine nor a pill; it is extremely unlikely that the exhausted radiologists in Wuhan, Qom or Bergamo download the Python code of our poorly trained network (using insufficient and improper data and described in quickly written papers and blogs) to just obtain a flawed second opinion.

Yes, we all want to help. Let us wait for real data from hospitals, let us do the ethics clearance and de-identification, and let us work with radiologists to develop solutions for chest issues of the future. Otherwise, we may create the impression that we are doing sensational research and are more concerned with self-promotion than with the well-being of patients. Radiologists are working day and night to understand the manifestation of this virus in medical images. Let us work with them and learn from them to unleash the true potential of AI for combating viral infections in the future.


Saturday, 11 September 2021

Sleep plays a key role in human function and cognition, affecting learning, memory, physical recovery, metabolism, and immunity. The functional role of sleep is well documented across species, and more recently, research has revealed the function of sleep in regulating emotion. The relationship between the two is reciprocal; sleep is crucial for mental and physical health while regulating emotion plays a vital role in decreasing the detrimental effects of emotional stress on sleep physiology.

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How does sleep affect the processing positive and negative stimuli?

It is widely accepted that sleep is strongly implicated in the processing of daily stresses and emotions. Scientific literature has shown how sleep appears essential to our ability to cope with emotional stress in everyday life. Sleep loss and insomnia have been found to affect emotional reactivity and socialization. The effect of sleep has been well documented at various levels of function, such as on the psychomotor, sensory-motor, and cognitive levels; however, the emotional effects are less descriptive.

However, in general, the reaction to negative emotion has been documented to be significantly enhanced, while reactions to positive events are often subdued. A sleep deprivation study found that the response to positive stimuli was faster relative to the response elicited from negative and neutral stimuli. Other studies have corroborated this, showing that sleep loss increases subjective reports of stress, anxiety, and anger in response to low-stress situations and increases impulsivity towards negative stimuli. Notably, impulsivity is correlated with aggressive behavior – a tendency associated with sleep deprivation.

In another sleep deprivation study, 33 participants were subject to repeated functional magnetic resonance imaging (fMRI) sessions to determine the effect of 42 hours of sleep deprivation and after sleep recovery on brain responses and circadian rhythm in 33 healthy participants. The results showed participants' feelings of emotional distress (negative affect) remained comparatively stable during the first day, later significantly worsening after the first and second melatonin onsets in their circadian rhythm, which signals sleep.

The disruption or deprivation of sleep is both a symptom and a risk factor for several psychiatric disorders. In studies with children and young adults, insufficient sleep has increased incidents of confusion, anger, and depression alongside feelings of irritability, aggression, and frustration. This occurred in even as little as one night of sleep deprivation; subjects saw an increase in psychopathology schools for anxiety, depression, and paranoia. In this same research group, sleep deprivation was associated with a decreased ability to accept blame.

The long term effects of sleep deprivation on mental health

Sleep disturbances impede a sense of well-being and may affect the development and prognostic outcomes of affective disorders like depression. Since both rapid eye movement (REM) and non-REM (NREM) sleep help modulate emotional and motivational drives, these two sleep phases allow greater emotional capacity and adaptiveness during wakefulness. Healthy sleep repairs functional brain activity and adaptive processing. The integrity of the medial prefrontal cortex-amygdala connections is important in emotion regulation processes. Indeed, one night of sleep deprivation triggers a 60% amplification in the amygdala's reactivity to emotionally negative pictures relative to a normal night of sleep.

Another main aspect of regulation is the regulatory action of the hormone cortisol, which is involved in the control of stress and reactivity against emotions. Melatonin, which can regulate the reaction of cortisol, is a source of circadian disturbance and explains the change in emotional reactivity and alteration of the circadian cycle as a result of sleep deprivation – which is a source of emotional dysregulation.

As well as the exacerbation of emotional reactivity and responses to fear, sleep can create a negative outlook and increased levels of anxiety. Collectively, research demonstrates that sleep deprivation increases worry about future events, particularly if subjects are predisposed to anxiety in general. In one such study, sleep deprivation was found to increase anticipatory anxiety. Brain scans of 18 healthy young adults observing images containing emotionally disturbing or emotionally neutral content were used to trigger anticipatory anxiety. Ahead of viewing these images, subjects, when well-rested and subsequently sleep-deprived, were given visual cues before each series of images to convey the emotion to be elicited (neutral, negative, or either). Brain activity in response to the anticipatory signal was greater when the participants were sleep-deprived relative to the well-rested state, and this was pronounced in response to participants waiting in suspenseful anticipation. These responses were found to be particularly pronounced in the amygdala and the insular cortex. This was particularly amplified in subjects who were reported to be innately anxious. Explanations for this difference are attributed to changes in the amygdala, the emotional control center. Here, sleep-deprived participants show a 60% higher level of activity in this area relative to the well-rested state. Moreover, sleep deprivation has been found to disrupt the connection between the amygdala and the medial prefrontal cortex – this area regulates the amygdala function. Sleep deprivation causes the amygdala to overreact to negative stimuli as it becomes disconnected from brain areas that normally moderate its responses.

Sleep loss is also associated with reduced empathy and emotional recognition; therefore, poor sleep may reduce understanding between partners in a relationship, increasing the potential for conflict. Reduced empathy and empathic accuracy are also associated with increased levels of miscommunication and increased propensity to retaliate during conflict. These effects are linked to another finding; just one night of sleep loss impairs problem-solving, exacerbating an inability to resolve conflict.

Sleep loss compromises optimal effective functioning, affecting emotion generation the ability to regulate emotions and express them. The consensus is that getting an adequate amount of sleep each night promotes improved mood and health.


Thursday, 9 September 2021

The primary role of a nurse is to advocate and care for individuals and support them through health and illness. However, there are various other responsibilities of a nurse that form a part of the role of a nurse, including to:

◉ Record medical history and symptoms

◉ Collaborate with teams to plan for patient care

◉ Advocate for the health and wellbeing of patients

◉ Monitor patient health and record signs

◉ Administer medications and treatments

◉ Operate medical equipment

◉ Perform diagnostic tests

◉ Educate patients about management of illnesses

◉ Provide support and advice to patients

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Patient care

A nurse is a caregiver for patients and helps to manage physical needs, prevent illness, and treat health conditions. To do this, they need to observe and monitor the patient, recording any relevant information to aid in treatment decision-making.

Throughout the treatment process, the nurse follows the progress of the patient and acts accordingly with the patient’s best interests in mind. The care provided by a nurse extends beyond the administration of medications and other therapies. They are responsible for the holistic care of patients, which encompasses the psychosocial, developmental, cultural, and spiritual needs of the individual.

Patient advocacy

The patient is the first priority of the nurse. The role of the nurse is to advocate for the best interests of the patient and to maintain the patient’s dignity throughout treatment and care. This may include making suggestions in the treatment plan of patients, in collaboration with other health professionals.

This is particularly important because patients who are unwell are often unable to comprehend medical situations and act as they usually would. It is the role of the nurse to support the patient and represent the patient's best interests at all times, especially when treatment decisions are being made.

Planning of care

A nurse is directly involved in the decision-making process for the treatment of patients. It is important that they are able to think critically when assessing patient signs and identifying potential problems so that they can make the appropriate recommendations and actions.

As other health professionals, such as doctors or specialists, are usually in charge of making the final treatment decisions, nurses should be able to communicate information regarding patient health effectively. Nurses are the most familiar with the individual patient situation as they monitor their signs and symptoms on an ongoing basis and should collaborate with other members of the medical team to promote the best patient health outcomes.

Patient Education and Support

Nurses are also responsible for ensuring that patients are able to understand their health, illnesses, medications, and treatments to the best of their ability. This is of the essence when patients are discharged from hospital and need to take control of their own treatments.

A nurse should take the time to explain to the patient and their family or caregiver what to do and what to expect when they leave the hospital or medical clinic. They should also make sure that the patient feels supported and knows where to seek additional information.




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