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This article is written by Jennifer L.W. Fink and was originally published in Campaign for Action’s Charting Nursing’s Future on June 25, 2018.

 

Truck drivers’ health affects us all. According to a 2017 study published in the Journal of Occupational and Environmental Medicine, commercial truck drivers with three or more medical conditions have two to four times the risk for being in a crash compared to healthier drivers.

For decades, many medical examiners—typically physicians—would sign off on truck driver fitness after a perfunctory exam. “When I’d drive into Georgia on Interstate 75, I’d see billboards that read: $10/DOT Physicals, guaranteed to pass,” said Wendy Paracka, MS, ARNP-BC, FAANP, owner and founder of Remise Health Solutions in Florida.

The Department of Transportation (DOT) requires all truck drivers to undergo a DOT physical at least every 24 months. In 2012, after a series of high-profile accidents, DOT’s Federal Motor Carrier Safety Administration started requiring that clinicians be nationally certified. That new certification test was opened to “any licensed healthcare provider licensed by the state to perform physical examinations,” including nurse practitioners (NPs), and other advanced practice registered nurses (APRNs).

NPs such as Paracka stepped up in large numbers. Since the final rule went into effect in 2014, NPs and other APRNs have accounted for roughly a third of DOT-certified medical examiners see the exam as a starting point for working with truckers to actively improve their health.

“The goal is not just pass or fail a DOT physical, but how can we help you have a long career? How can we help you stay on the road, be healthy, live a long life and enjoy your family?” says Kathleen Dailey, DNP, FNP-C, DOT-CME, senior education leader with CVS Health’s MinuteClinic, a leading provider of DOT physicals.

“If they don’t have a primary care provider, we look to get them a primary medical home. If they can’t get to their medical home, we look to fill the gap. If they have a chronic illness, we can help them with managing it,” says CVS’s Dailey.

You can read the rest of this article here

 

This article is written by Jennifer L.W. Fink and

This article was published first on June 25, 2018, in Perspectives, a publication of the National Academy of Medicine. Follow them on Twitter @theNAMedicine

Nursing, Trauma, and Reflective Writing

By Joy Jacobson and Pamela R. Jeffries
June 25, 2018 | Discussion Paper

The young nurse returned to room seven. Finishing up her charting just a moment earlier, she glanced at her watch and knew she couldn’t postpone going into his room any longer, despite the disconcerting vibe she got each time she went in there.

Room seven was still dark and the patient was still grinning. Glasses were still cloudy and eyes were still staring. Scanning the room, the young nurse realized that she and the doctor had left the place in shambles in their rush to escape. As she started to gather the waste, she noted a capped, pink syringe, the 20-gauger from the failed attempt [at IV insertion] earlier. The young nurse inwardly groaned. Had her manager made it in there before her, she would have never heard the end of it: You left a needle within reach of an encephalopathic patient?? What were you thinking?!

Well, she certainly was thinking now. She picked up the needle and felt a stab.

Jordana Kozupsky refers to herself in the third person in this excerpt from a narrative essay, “My Infected Reality,” that she composed in a writing course for graduate nursing students in 2015. Here, the nurse returns to the room of a patient infected with HIV who had violently resisted her and a physician’s earlier attempts at inserting an IV.

Did the needle pierce the patient’s skin before penetrating her own, thus exposing her to a serious infectious disease? She can’t be sure, and Jordana’s reality becomes infected by panic, flashbacks, and nightmares, leaving her unable to take the step of getting tested. Her writing explores an unfortunately common workplace trauma for nurses—needlestick and its aftermath—by echoing its disturbing effects on her life.

Continue to read the full article on Perspectives here:

This article was published first on June

The United States has one of, if not the worst, maternal mortality rate in the developed world. while global maternal death rates have dropped by more than a third from 2000 to 2015, the rate in the United States has more than doubled since 1987. According to the Center for Disease Control and Prevention (CDC), about 700 women in the United States die each year as a result of complications related to pregnancy or childbirth.   Black women bear the greatest risk of maternal death.

Racism is making people sick — especially black women and babies, says Miriam Zoila Pérez. The doula turned journalist talks with producer Dr. Kenya Beard about the relationship between race, class and illness.

You can listen to the interview here:

The United States has one of, if