Cases of Necrotizing Fasciitis, Serious Genital Infection with certain Diabetic Medications, FDA warns

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The US Food and Drug Administration has put out a warning about certain Type II Diabetes medications causing cases of genital infection and necrotizing fasciitis in the perineum.

According to Medscape

“The new warning will be added to the prescribing information and the patient medication guides for all single and combination agents in the glucose-lowering SGLT2 inhibitor class of drugs approved to treat type 2 diabetes. Those drugs include the following:

  • Canagliflozin (Invokana, Invokamet, Invokamet XR; Janssen)
  • Dapagliflozin (Farxiga, Xigduo XR, Qtern, AstraZeneca)
  • Empagliflozin (Jardiance, Glyxambi, Synjardy, Synjardy XR; Boehringer Ingelheim/Eli Lilly)
  • Ertugliflozin (Steglatro, Segluromet, Stelujan; Merck)

Necrotizing fasciitis of the perineum, also called Fournier’s gangrene, is an extremely rare but life-threatening bacterial infection of the tissues underlying the skin surrounding the perineal muscles, nerves, fat, and blood vessels. It is estimated to occur in about 1.6 of 100,000 males annually in the United States, most often among those aged 50 to 79 years (3.3/100,000).

However, from March 2013 to May 2018, the FDA received reports of 12 cases of Fournier’s gangrene among patients taking SGLT2 inhibitors, of whom five were women and seven were men. The condition has rarely been reported among women. The patients ranged in age from 38 to 78 years.”

Read on at Medscape to find out about treatment options and what patients and healthcare professionals should do.

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A Pause At The Door: Regaining Time with Patients

By | Blog, Kathleen Bartholomew | No Comments
Here is another excellent guest post by Kathleen Bartholomew, author of the book The Dauntless Nurse and website I am Dauntless.

I recently read that 70% of physicians said that their bond with their patients has eroded. I wonder what the statistic is for nurses? I’m guessing even lower as electronic charting takes up more than 30% of our time, and hospitals crunch staffing grids for survival.

Forming a bond takes time.

I remember an older man who seemed to be fighting death with all he had – even the doctor was perplexed! Finally I asked everyone to leave and listened carefully to his incoherent mumbling while giving him a bath. I discovered that when he was only 19 he had joined the Navy and gone to a brothel and was terrified of going to hell. I provided comfort and reassurance. There is no pill for a peaceful death. He died serenely within the hour.

Share your story! The stories of our bonds with our patients energize us and remind us why this profession is so amazing.

Maybe this lack of time explains why nurses have twice the depression rate – 18.2% compared to 9% for the general population. The time we have to listen and connect has eroded like a massive mudslide over the last 10 years as acuity and complexity increased and length of stay became shorter. As humans, we don’t notice minute changes because we are so awesome at adapting. How can we can reclaim this time with our patients again, and protect it from eroding even more? It was, and will always be, time with my patients that nourishes my soul and validates why I chose nursing in the first place.

What tips or tools have you found that are helpful to regain quality time with your patients? Try the ‘pause at the door’. Just stopping at the threshold before entering a patient’s room long enough to inhale and exhale deeply two times will have a centering effect on your nervous systems. When you have a list of 20 things to do, and medications are late, and someone turned up the invisible treadmill to high, use breathing as a powerful way to stop the crazy cycle. And any intervention that helps a nurse, helps the patient.

Try it!

Don’t miss Kathleen’s other guest posts

How Much Weed is Too Much Weed for Nurses

It all comes back to staffing

Late to the game:What can China and South Korea teach America?

A Loneliness Epidemic

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A Loneliness Epidemic

By | Blog, Kathleen Bartholomew, Public Health | No Comments

Kathleen Bartholomew is back with another excellent blog post. Kathleen is a well known Nurse speaker and the author of “The Dauntless Nurse”. She can be found at her website Kathleen Bartholomew as well I Am Dauntless.  You don’t want to miss her other posts on the SMYS Blog How Much Weed is Too Much Weed for NursesIt all comes back to staffing, and Late to the game:What can China and South Korea teach America?

 

Just this week a survey of 20,000 adults conducted for the health insurer Cigna found that 50% of adults said they sometimes or always felt alone or left out. That’s a big leap from 1985 when only 10% of our population had no one to confide in about serious matters.

Can you guess which age group was the worst affected? Ages 18-22. Alarming!

In our Instagram world where we are constantly texting friends and family, the Great Nothing of loneliness has taken up residence in our souls. What gives? It turns out that a “like” is not the same as real human connection where we feel truly seen.

Most nurses know that loneliness is a predictor of functional decline and mortality and is associated with depression, poverty, arthritis, and heart and lung disease. A 2010 study found that being lonely has the same effect on mortality as smoking 15 cigarettes a day!

Let’s recognize outliers and do something about strengthening community before Loneliness turns into yet another billing code and treatable commodity where big pharma can make big money by creating new drugs like “Forlorn-azol”, or immunize us from loneliness with “Dejectacillan”.

Look around. A good place to start is your own unit. Engage in conversation with someone new, initiate genuine conversation instead of always diverting into our own smartphones at breaks, and discover something unique and good to say about a co-worker every day.

We are over 3.6 million nurses. We can reverse this trend.

Tell us what you think in the comments section and over on the SMYS Facebook Page and join us in the SMYS Facebook Group

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Happy Nurses Week – SMYS members give of themselves for Hurricane Harvey and Christmas

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This week we have witnessed that SMYS Nurses take care of themselves on the SMYS Cruise, take care of others around the world with Medical Mission trips, take care of our own by providing tranquility in Las Vegas in times of tragedy, and that is not even the end of how SMYS Nurses, and other members, rise to the challenge of giving of ourselves in times of need.

 

This past year Hurricane Harvey struck the gulf coast, causing massive destruction to homes and infrastructure, leaving many homeless, without resources and care. Hurricane Harvey caused $125 billion in damage and displaced 30,000 people.  The flooding in Houston and other areas of the Gulf Coast was devastating and required harrowing evacuations, but when the storm settled, and people needed to return to what was left of their homes, the devastation of what happened became more and more evident.

SMYS members on the ground were able to quickly mobilize and arrived in the shelters to organize and coordinate supplies and other needs, being able to get there in the days and hours before groups like the Red Cross were able to deploy.  SMYS members online, in addition to sending supplies, partnered with Physician Moms Group to raise $12,000 to help rebuild infrastructure for some of the area schools.  Once again the Nation of Nurses rose to the challenge of helping those in need when disaster struck.

 

Not only does the Nation of Nurses rise to the challenge when disaster strikes the country, but they rise to the challenge when personal disasters strike. At Christmas, keeping with the tradition of previous years, the Nation Of Nurses once again adopted dozens of families.  Some of these families suffered great losses due to fires, natural disasters, unexpected deaths of loved ones, or having had to suddenly deal with diseases that left them unable to work.  Over the past 3 years SMYS has adopted 100 families at Christmas time, helping to ensure that others have a holiday season that is Merry and Bright. SMYS members went above and beyond to embody the spirit of SMYS and Christmas, purchasing all of the gifts for these families who otherwise would not have been able to have Christmas gifts.  So many children were able to experience some joy over the past three years thanks to the generosity of SMYS members. We’re so thankful to all of the SMYS members who donated and helped give these families a wonderful holiday season.

Happy Nurses Week from the entire Show Me Your Stethoscope Team!

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Happy Nurses Week – Las Vegas Tranquility Room

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The Nation of Nurses relaxed on a cruise, gave of themselves in service to others on medical mission trips, and now, when our fellow healthcare professionals need us most, when it is time to care for our colleagues, the Nation of Nurses once again stepped up to answer the call.

After the terrible events of the Las Vegas mass shooting, Nurses and other healthcare professionals, from around the United States, supported front line Nurses and staff by providing meals for those working. Months after the media attention faded, these front line Nurse were still grappling with the stress and emotional trauma of working the mass casualty. Again, SMYS members stepped up and provided a real solution to help them cope by financing a sanctuary room in the hospital. This place was designed by Nurses for Nurses to offer a place for them to rest, decompress, and find tranquility for a few minutes during their often chaotic shifts.

We are so proud of the SMYS Nation of Nurses and their dedication to taking care of each other.

Remember to catch the other Nurses Week Posts Happy Nurses Week -SMYS Cruise! and Happy Nurses Week Medical Missions!

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