Nursing in the Headlines

Every year, we celebrate National Nurses Week between May 6, which is National Nurses Day, and May 12, which happens to be Florence Nightingale’s birthday. If you haven’t picked up a specialty journal or public newspaper in the past few months, you may not know that nursing has made it to the headlines:


Some of us might argue that any press is better than none, and others might say it’s about time that the real story about nurses and nursing become better known. While I believe a little in both perspectives, the real reason I’m glad to see them today is that they depict a much richer, more valid, and more robust story about who and what nurses are and how they serve society.

A recent article in The New York Times stated, “A Shrinking Band of Southern Nurses, Neck Deep in Another Covid Wave.” This news story brings into national view the importance of small, nonprofit safety-net hospitals and the experience of the nurses who work there. Told without romanticizing nurses’ dedication or pointing out their long-suffering compassionate nature, this article tells of the real challenges faced by nurses who want to do good for their communities but are faced with persistent shortages, significant illnesses that could have been avoided, and politically motivated, bureaucratic financial decisions. However, it also tells of the creative problem solving demonstrated by these nurses as they try to meet patient needs and the compassion they provide to their colleagues as they continue, yet another day, to address the needs of many with fewer and fewer resources.

Look at the first three headlines: together, these depict a professional field dedicated to meeting the conditions of its social contract—to provide high-quality patient care—and awash with opportunities for outstanding career growth, and at the same time at risk of losing some of its critical workforce due to unrelenting stress in the workplace. What does this say about nursing? Never has there been such opportunity, but never has the opportunity promised so little.

A beautiful story in March in The New York Times, “Confronting Grief, With Margaret Atwood, in ‘The Nurse Antigone,’” which talks about regular nurses participating with Margaret Atwood in the reading of the play Antigone, provides me with hope and vision. In this rendition, Atwood will play the blind prophet Theophanes and the nurses will be part of the Greek chorus. This story of Antigone’s determination to bury her brother, who died in battle, despite a law forbidding the burial of traitors mirrors the challenges nurses face by attending to those in need despite enormous challenges in acquiring resources needed to provide care, including sufficient time. An ethicist quoted in the article remarks that Antigone’s triumph over Creon’s prohibitions provides an apt mirror of the moral injury with which nurses cope, neither romanticizing their decision nor despairing at their deplorable conditions.

The final headline in the middle of the pack heralds nurses’ awakening to their economic power. The COVID-19 pandemic didn’t create the traveling nurse sector of our profession, but it certainly accelerated its growth across the country. Individual remuneration soared, leaving many nurses with the dilemma to remain as a loyal worker in a long-served institution or move on for financial gain. Hospitals too faced the challenge of differential staff compensation, with highly paid traveling nurse staff working next to more modestly paid existing staff. Fortunately, the perversity of this economic structure has led to hospitals and clinics improving staff nurse compensation, attending to their work conditions, and stabilizing the staffing complement.

As we celebrate National Nurses Week this year, please join me in recognizing the vibrant, rich picture of our profession. We are not unbuffered by these challenging times, and as a profession, we are responding in a way that serves our patients while preserving our profession. Accepting new models of care, innovative career trajectories, and an expanded understanding of how to create compassionate workplaces promises a future in which all nurses can work to the top of their licenses. Let us know how we can help you do this, too!

Recognizing Women in History All Year Round

Women in history — and women making history — featured in this post.
From left to right in the top row: Mary Lasker, Elizabeth Blackwell, Hope Hopps, Florence Sabin, Margaret Pittman, Patricia Palma, and Selma DeBakey. Middle row: Faye Abdellah, Deirdre Cooper Owens, Rosalind Franklin, Inez Holmes, Alice Evans, and Lois DeBakey. Bottom row: Maxine Singer, Virginia Apgar, Barbara McClintock, Sarah Stewart, Bernadine Healy, and Rana Hogarth.

Guest post by Susan L. Speaker, PhD, Historian for the Digital Manuscripts Program of the History of Medicine Division (HMD) at the NIH National Library of Medicine (NLM), and Jeffrey S. Reznick, PhD, Chief of HMD at NLM.

One important role of NLM staff is to research, curate, explain, and make available historical collection materials. In doing so, our historians, librarians, archivists, and exhibition specialists prioritize the history of underrepresented groups, stories of advocacy and change, and materials that demonstrate the relevance of history to current events. Although this Women’s History Month will soon conclude, we recognize women who have made a difference in the history of health care and medicine — as well as women who make history — year round.

NLM’s collections span ten centuries, encompass a variety of digital and physical formats, and originate from nearly every part of the globe. For many years, through a constellation of research, curation, and public programs connected to these collections, we have shared the stories of women — healers, naturalists, midwives, nurses, physicians, scientists, artists, advocates, and patients.

These individuals have included — among many others — Faye Abdellah, who became the first nurse to achieve the rank of Rear Admiral, Upper Half, a two-star rank, in the U.S. uniformed services, as well as the first nurse and woman in the 200-year history of the United States Public Health Service to hold the distinguished position of Deputy Surgeon General; Virginia Apgar, the neonatologist who developed the Apgar scoring system for evaluating newborns; and Elizabeth Blackwell, the first woman to receive a Doctor of Medicine degree from an American medical school, overcoming many obstacles and establishing a foundation for American women physicians. We have also featured Selma and Lois DeBakey, icons of both medical literature preservation and communications; Bernadine Healy, the first female Director of the NIH, and Inez Holmes, World War II veteran and nurse who trained at the Piedmont Tuberculosis Sanatorium for the treatment of African American patients in Virginia.

Among the others we have recognized through our curation are geneticists Barbara McClintock and Maxine Singer; chemist and crystallographer Rosalind Franklin, whose X-ray diffraction images of DNA revealed its helical structure; embryologist, cell physiologist, and public health administrator Florence Sabin; and philanthropist Mary Lasker, whose public health advocacy helped to spur a vast expansion of NIH.

Through our curation we have also brought forward historical knowledge about many groups of women and their wide-ranging experiences, expertise, interests, and roles in medicine and science. These groups have included women of the Frontier Nursing Service, women who composed unique, handwritten “receipt” books in which they noted, tested, and revised formulas for household remedies for common medical problems, as well as women physicians and nurses in the armed services of World War I and World War II. We have also told important stories about women who changed the face of medicine through their leadership and expertise, and those who confronted domestic violence and improved women’s lives.

We have also shown how women’s historical presence is sometimes obscured in larger accounts and must be made visible through careful reading and piecing together textual and visual evidence. Such curation enables us to reveal the stories of women who worked in labs at NIH, like Hope Hopps, as well as lab workers who worked in the California State Hygiene Lab in Berkeley just before World War I, and medical students who gathered tuberculosis patient data at Johns Hopkins University at the turn of the last century. NLM is also steward of the papers of early twentieth-century women bacteriologists whose important work is not widely known, including Alice Evans, Sarah Stewart, and Margaret Pittman. We collect and make these papers available to interested investigators, preserving their stories for future research.

Along with our many efforts focused on highlighting the experiences and voices of women in our collections, we also amplify the voices of today’s women historians, especially those from underrepresented backgrounds, who have studied our collections to advance their research. This month, we welcomed to our NLM History Talk series Patricia Palma, PhD, Assistant Professor in the Department of Historical and Geographic Sciences at the University of Tarapacá, Arica, Chile. Dr. Palma spoke about her research on homeopathic therapies in Peru during the late-nineteenth and early twentieth centuries, drawing on unique materials held by our institution. Last month, we welcomed Deirdre Cooper Owens, PhD, the Charles and Linda Wilson Professor in the History of Medicine & Director of the Humanities in Medicine Program, University of Nebraska-Lincoln. Dr. Cooper Owens spoke about women whose stories of enslavement are part of the history of gynecology in the United States. In April, we will welcome Rana A. Hogarth, PhD, Associate Professor of History at the University of Illinois, Urbana-Champaign, who will speak on how people of African descent became targets of eugenic study during the early decades of the twentieth century. 

Notably, many of these curatorial efforts are themselves brought you by the women of NLM —archivists, librarians, historians, and exhibition and technical specialists. So, as we work year round to recognize women in history and connect with women making history, we also recognize each and every one of our colleagues who are themselves making history through their public service here in the world’s largest biomedical library!

Dr. Speaker has been Historian for the Digital Manuscripts Program since 2002. She conducts research, selects documents, and writes in-depth contextual narratives for the Profiles in Science project, and she carries out other historical work for HMD including articles, blog posts, presentations, and oral histories on a variety of topics. She is also the historical consultant for the NLM Web Collecting and Archiving Working Group. Dr. Speaker is a graduate of the University of Pennsylvania.

As Chief of the NLM HMD, Dr. Reznick leads all aspects of the division in cooperation with his colleagues and has over two decades of leadership experience in federal, national-nonprofit, and academic spaces. As a cultural historian, he also maintains a diverse, interdisciplinary, and highly collaborative historical research portfolio supported by the library and based on its diverse collections and associated programs. Dr. Reznick is author of three books and numerous book chapters and journal articles, including, as co-author with his colleague Kenneth M. Koyle of “History matters: in the past, present & future of the NLM” published by the Journal of the Medical Library Association in 2021.

Learn more about many more women in medical history—and women making medical history—through the NLM HMD blog Circulating Now, Profiles in Science, @nlm_collections on Instagram, and the free NIH Videocast archive of NLM History Talks

Celebrate St. Patrick’s Day Safely

Guest post by George F. Koob, PhD, Director of the NIH National Institute on Alcohol Abuse and Alcoholism (NIAAA).

 Alcohol-induced blackouts are gaps in a person’s memory for events that occurred while they were intoxicated. During alcohol-induced blackouts, which are linked to high BAC, people remain conscious, but they can’t remember events that occurred while drinking. They can occur when someone drinks on an empty stomach, drinks quickly, or engages in binge drinking. At high BACs, most cognitive abilities (e.g., impulse control, attention, judgment, and decision-making) are significantly impaired, making the intoxication level associated with blackouts especially dangerous.

Happy Saint Patrick’s Day! Because drinking alcohol is a large part of the St. Patrick’s Day festivities for many people, this is a good time to be mindful of how alcohol can impact your celebrations and your health.

Some people may binge drink on St. Patrick’s Day. Binge drinking is a pattern of drinking that brings blood alcohol concentration (BAC) to a level of 0.08% — the legal limit for driving in the United States — or higher. This typically occurs after 4 drinks for women and 5 drinks for men in about 2 hours.

Binge drinking is dangerous. Serious safety risks include unintentional injuries from car crashes and falls, as well as alcohol-induced blackouts and overdoses. Binge drinking also increases the risk of sexually transmitted infections and unintended pregnancies. Even a BAC less than 0.08% can result in memory impairment and attention and coordination issues that may put people at risk for unintentional injuries.

An alcohol overdose occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions begin to shut down. Symptoms of alcohol overdose include mental confusion, difficulty remaining conscious, vomiting, seizures, trouble breathing, slow heart rate, clammy skin, dulled responses such as no gag reflex (which prevents choking), and extremely low body temperature. Alcohol overdose can lead to permanent brain damage or death. If you suspect that someone has an alcohol overdose, call 911 immediately.

It’s important to note that drinking even small amounts of alcohol can pose risks to your health under certain conditions. For example, drinking any amount could pose a risk if you have a chronic health condition, such as high blood pressure or diabetes, or take a medication that interacts badly with alcohol — an effect that can be potentially fatal. It is safest for women to avoid alcohol altogether if they are pregnant or trying to become pregnant.

Individuals who don’t typically drink much alcohol or who are not familiar with the alcohol content of certain alcoholic beverages may indulge more than usual during holidays and other events. As a result, they may underestimate their level of alcohol consumption and not recognize their level of impairment, leading to potentially hazardous situations.

Tips for a healthy holiday

Common over-the-counter and prescription medications known to interact with alcohol include aspirin, acetaminophen, cold and allergy medicines, cough syrup, sleeping pills, narcotic pain medications, and anxiety or depression medicines as well as some herbal remedies. Since these medications can take time to clear the body, problems can occur even if they are taken several hours before or after consuming alcohol. The combination of consuming alcohol and using a prescription sedative-hypnotic or opioid pain reliever can be deadly.

This week and during all holidays please be mindful of how much alcohol constitutes a standard alcohol drink and how much you are consuming. If you are hosting a party, be sure to have plenty of alcohol-free drinks and snacks available for your guests. Mocktails are growing in popularity and could be an alcohol-free option. Such items can help people stay hydrated and/or slow the absorption of alcohol in the body, thereby reducing peak alcohol concentration in the blood. It is important to take the necessary steps to help ensure your well-being and the safety of your guests.

NIAAA’s alcohol calculators can help you assess the alcohol content of beverages in common container sizes, such as a beer and the number of standard drinks in a cocktail — and help predict blood alcohol concentrations and calorie consumption.

Dr. Koob is an internationally recognized expert on alcohol, stress, and the neurobiology of alcohol and drug addiction. At NIAAA, Dr. Koob provides leadership in the national effort to reduce the public health burden associated with alcohol misuse. Dr. Koob also oversees a broad portfolio of alcohol research ranging from basic science to epidemiology, diagnostics, prevention, and treatment. He also is a Senior Investigator at the NIH National Institute on Drug Abuse, where his laboratory is studying the neurobiology of drug and alcohol addiction

Happy Heart Health Month, Valentine!

This week in the United States, along with many other countries around the world, we celebrate Valentine’s Day. Valentine’s Day celebrations have varied over the centuries, and many of us, myself included, send greetings to those we love — spouses, children, and dear friends — to strengthen the bond of affection. Valentine’s Day was first marked as a romantic celebration during the reign of Emperor Claudius II around AD 270, when St. Valentine labored to heal the hearts and bodies of those imprisoned by the emperor. His kindnesses not only provided a sense of being loved and supported, but also, according to some legends, even brought at least one person back from the dead. So, for more than two millennia, people have linked the ideas of affection and healthy hearts.

However, if you scan even a few of the more than 33 million citations in NLM’s PubMed biomedical literature database, you’ll find that we now know that it takes more than affection to make a heart healthy and, in turn, a healthy heart powers one to build affectionate bonds with others!

Medicine and healthy lifestyles go together to make healthy hearts! We’ve got research showing how lifestyle modifications can help prevent AND treat heart failure and how medications, in addition to lifestyle behaviors including regular physical activity, can help with the management of high blood pressure. There’s also research proposing an explanation of why loneliness disrupts metabolic pathways that contribute to cardiovascular disease (conditions affecting the heart or blood vessels), and how social relationships can influence the risk of death.   

Healthy lifestyle and self-care concept with food, sports and nature icons arranged in a heart shape

Yet, even though we know so much about how to keep our hearts healthy, heart disease is the leading cause of death in the United States, causing one in four deaths each year. Despite significant progress in reducing deaths from heart disease, which have been declining since 1950, this progress appears to have stalled in some parts of the country.

Why, if we know what to do, do we not take steps that are effective in improving heart health?

Well, looking back through our PubMed holdings, you can find many explanations for why health behavior changes have not occurred, and what might be done to alter this course. I am encouraged by the re-examination of theories of behavior change with a call to take into account the social, cultural, and economic factors that influence behavior. This perspective matches well the work of one of my NIH colleagues, Shannon N. Zenk, PhD, MPH, RN, FAAN. Dr. Zenk is the Director of the National Institute of Nursing Research and established a program for research examining how neighborhoods, food choice options, and socioeconomic status contributes to health outcomes. The right combination of personal action and communities designed to help people adopt healthy lifestyle behaviors may be just what we need to complement the effective use of medications. There’s hope for those healthy hearts!!

So, this year, as you connect to the hearts you love, make sure you connect to the heart most important to you – your own! Small acts of self-care, like taking walks, getting quality sleep, and making healthy meals, help your heart. And don’t forget to nurture the relationships with those you love – you’ll improve your chances to love longer!

Ending the HIV Epidemic: Equitable Access, Everyone’s Voice

A guest post by Amanda J. Wilson, Chief, Office of Engagement and Training; Leigh Samsel, NLM Planning and Evaluation Officer, Office of Strategic Initiatives; and Elizabeth A. Mullen, Manager of Web Development and Social Media, History of Medicine Division, National Library of Medicine at the National Institutes of Health.

This year’s theme for World AIDS Day is Ending the HIV Epidemic: Equitable Access, Everyone’s Voice. As the world’s largest biomedical library, NLM has a long history of supporting NIH’s efforts to end the HIV epidemic by providing equitable access to trusted biomedical information, supporting biomedical research, and highlighting the historical, social, and cultural context of this research. Expedient, reliable, free public access to NLM’s trusted biomedical information resources and literature collections advances the knowledge and treatment of HIV/AIDS worldwide, helps progress research to end the HIV epidemic and improves the health of people living with HIV.

Improving HIV/AIDS Health Information Access

NLM integrates multiple types of HIV literature, sequence, testing, and clinical trials data into a portfolio of resources that enables researchers to easily find related information and robustly supports global research to end the HIV epidemic. Free public access to citations to the scholarly literature is provided through NLM’s PubMed and Bookshelf, while free access to full-text is provided through PubMed Central and NLM Digital CollectionsGenBank and the Sequence Read Archive allow researchers to deposit and access publicly available DNA sequences, including HIV experimental and clinical genome sequences. NCBI Virus makes HIV and other virus sequences from RefSeq, GenBank, and other NLM repositories available. The HIV-1 Human Interaction Database includes information gleaned from literature about the interaction between human and HIV-1 genes and proteins.

NLM also provides a rich resource of easy-to-understand online health and wellness information available in English and Spanish via MedlinePlus. Among its wealth of content, MedlinePlus contains several HIV/AIDS topical pages. NLM supports an equitable distribution of information by providing resources and support to strengthen skills and literacies needed to access and use biomedical information for those affected by HIV/AIDS. The Network of the National Library of Medicine provides free health information training, from webinars to instructor-led classes to on-demand tutorials. Additional trainings on a variety of topics are added weekly.

A Long History of Support

NLM’s engagement and collections activities strive to capture the many voices in and around the HIV epidemic. A key historical partnership for engagement with the NIH Office of AIDS Research was the HIV/AIDS Community Information Outreach Program; beginning in 1994 as a resource for community-based organizations to improve the knowledge, skills, and technical means to access and provide the latest authoritative prevention, treatment, and research information electronically. The current iteration of the program concludes this month with 200 plus organizations conducting more than 350  projects in 38 states providing training, communications campaigns, and enhanced products and apps to raise awareness of HIV/AIDS information and discoveries over the 40-year history.

NLM has been collecting publications and archival materials related to HIV/AIDS since the first Morbidity and Mortality Weekly Report on the topic was issued in June 1981. The NLM HIV/AIDS Web Archive offers more than 150 websites documenting the biomedical, clinical, cultural, and social aspects of HIV/AIDS in the early 21st century. This month you can look for new additions and resources.

World AIDS Day 2021

Screen shot of NLM's History of Medicine Division's exhibit entitled "AIDS, Posters and Stories of Public Health"

This month, to help mark World AIDS Day, NLM will launch a new online exhibition—A People’s History of Pandemic: AIDS, Posters, and Stories of Public Health. The NLM exhibition will cover the archive of public health posters about AIDS rooted in the cultural output of artists, activists, and community workers. Their work, specifically the use of personal narrative as a visual-art strategy, along with language and the collective process of creating AIDS posters, continues to broadcast the message that, 40 years after the crisis began, attention to AIDS has not diminished. In mid-December, NLM’s Profiles in Science, will release a curated collection of digitized primary source materials related to the United States National Commission on AIDS, dating from the mid-1980s through the early 1990s. Learn more about the diversity of NLM’s historical collections related to HIV/AIDS on Circulating Now.

As we mark this year’s World AIDS Day, NLM is proud to continue its efforts to provide global access to trusted resources; share the voices of those affected by HIV; and provide the foundation for researchers, clinicians, patients, and families to engage and answer the call to end the HIV epidemic.

Photo of Amanda Wilson

Amanda J. Wilson is Chief of the NLM Office of Engagement and Training (OET), bringing together general engagement, training, and outreach staff from across NLM to focus on NLM’s presence across the U.S. and internationally. OET is also home to the Environmental Health Information Partnership for NLM and coordinates the Network of the National Library of Medicine.

Photo of Leigh Samsel

Leigh Samsel, MS, is responsible for formal reporting of NLM activities and for providing staff leadership to strategic planning activities. Leigh is currently serving as NLM’s AIDS Coordinator to the NIH Office of AIDS Research.

Photo of Elizabeth Mullen

Elizabeth A. Mullen, MS, is Manager of Web Development and Social Media for the History of Medicine Division (HMD) and Managing Editor of Circulating Now, a blog featuring new research, curatorial insights, and news about NLM’s historical collections.

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