In response to a March 2020, New York State mandate, our elective surgery center began a physical and operational transformation to provide inpatient care to COVID-19 patients. Research study aims included (1) a description of the orthopaedic nurses' experience during the pandemic, and (2) tactics used to cope with related stress. Researchers used a descriptive, qualitative design to achieve study aims. During April to December 2020, nine nurses responded to seven open-ended, study prompts asking them to journal their thoughts about the pandemic. The majority (66%) of participants were experienced nurses and all provided direct patient care. Nurses provided 51 journal entries that generated 12 themes, which encapsulated their experience living through the pandemic: (1) Whirlwind, (2) War, (3) Control, (4) Death and Dying, (5) Staying Safe, (6) Loss, (7) Looking for Meaning, (8) Whatever It Takes, (9) Adaptability and Resilience, (10) What I Have Learned, (11) The New Normal, and (12) When Will This Be Over? Orthopaedic nurses in this study pivoted to the needs of patients requiring them to draw on all their training and resources. Nurses described the enormity and taxing nature of the viral threat and their ability to manage their well-being while caring for patients and loved ones, amidst social distancing and need for aggressive infection control. Support from peers and leadership were paramount factors in nurse coping. Positive thinking and personal resilience were considered essential. Most participants described personal growth; however, decreased participation in journal responses overtime, suggested emotional strain. Future studies should examine nurses' observations about the impact of changes to their practice brought on by the pandemic, and reliance on technology.

The United States remains plagued by racial, ethnic, gender, socioeconomic, and other inequities from which medicine, science, and medical publishing are not immune. At HSS Journal, we have taken the step of organizing a Diversity, Equity, and Inclusion (DEI) Committee of members of our editorial board. As committee chair (L.A.B), editor-in-chief (C.N.C.), and managing editor (J.J.) of the journal, we recognize that the need for change remains urgent: studies have shown that minority patients experience disparate health outcomes in general and in orthopedics specifically [1,6,7,13,15]. Reducing such disparities in health and health care requires a careful, dedicated, and aggressive restructuring of systems, mindsets, and cultures; indeed, DEI efforts in medical research are important because they allow physicians and other clinicians to better understand and serve patients [14], to spotlight emerging trends in disparities, and to intervene before harmful trends become solidified [1]. DEI efforts within orthopedic surgery are especially important, given the field’s persisting lack of gender, racial, and ethnic diversity in its workforce [3,8–11] and resulting health inequities [1]. Promotion of DEI in the fields concerned with musculoskeletal health will ultimately provide patients with greater access to the high-quality talent that is characteristic of diverse and inclusive workforces. Unfortunately, the world of scholarly journal publishing is not exempt from such inequities. A recent survey of editors at 25 leading medical and scientific journals found that more than 75% were white [12], and a study of the 15 highest-impact orthopedic journals found that women constituted just 9% of their editorial boards [5]. Our publisher, SAGE, has signed on as a partner in the Coalition for Diversity and Inclusion in Scholarly Communications, which was founded in 2017 in acknowledgment that scholarly publications are “truly a global enterprise yet that diversity is not reflected in our collective demographics” [2]. At HSS Journal, our DEI Committee has based our DEI strategy on 4 pillars intended to organize our commitment as editors, board members, and reviewers. The 4 pillars direct us to become more able, active, attentive, and accountable (the four A’s) in reaching our DEI goals and to better serve readers and authors. We aim to do the following to advance DEI at our journal.

Lesbian, gay, bisexual, and transgender elders continue to face health care disparities.

Regulations are raising awareness of the needs of gender-nonconforming patients.

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssueArchivesePub Ahead-of-Print Collections Acute/Critical CareContinuing EducationCOVID-19 Disaster and Emergency PreparednessEnvironmental Health and IssuesEthics Evidence-Based Practice, Step by StepFamily CaregiversFocus on DEIGeriatric NursingHolistic NursingIn The CommunityInfectious DiseaseInternational TopicsLegal ClinicMental HealthNurse WellbeingNursing Research, Step By StepNursing ResourcesPalliative CarePatient SafetyPolicy and PoliticsProfessional Development, Leadership and ScholarshipProfessional Partners Supporting Diverse Family Caregivers Across SettingsQI: Quality ImprovementResearchSocial Media and Information TechnologySpecial SupplementsStrip SavvySupporting Family Caregivers: No Longer Home AloneSystematic Reviews Step by StepTeaching For PracticeTransforming Care at the Bedside (TCAB)Uniforms (Nursing)Uniting States, Sharing StrategiesWomen's HealthWriting Resources Videos Videos WebinarsFor Authors Call for ManuscriptsSubmit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor PermissionsOpen Access Journal Info About the JournalAdvertising and BusinessAward WinnersBook of the Year AwardsContact InfoEditorial BoardInformation for FacultyInformation for MediaInformation for Peer ReviewersLetters to the EditorNurse Faculty Scholars / AJN Mentored Writing AwardReprintsRights and PermissionsSubscription ServicesNurses: Submit Your Photos! All Articles Images Videos Podcasts Blogs Advanced Search

Screening all children in primary care will require new roles for RNs and NPs.

A call to curtail migration out of Latin America and the Caribbean raises questions.

Narrative Matters Health AffairsVol. 34, No. 10: Variety Issue NARRATIVE MATTERSThe Donor At The VLAJoy Jacobson Affiliations Joy Jacobson ( [email protected] ) is the poet-in-residence at the Center for Health, Media, and Policy at Hunter College in New York, where she teaches narrative writing to nursing students, nursing faculty, and working clinicians. Her poems have appeared in Smartish Pace, Beloit Poetry Journal, The Examined Life, and other journals. PUBLISHED:October 2015No Accesshttps://doi.org/10.1377/hlthaff.2015.0780AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View article"The Donor At The VLA." Health Affairs, 34(10), pp. 1790–1791TOPICSOrgan donationOrgan transplantation Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 October 2015 Information Project HOPE—The People-to-People Health Foundation, Inc. PDF download

Should a 60-year-old who’s smoked a pack of cigarettes a day for 30 years be screened for lung cancer using low-dose computed tomographic (CT) scanning? What about a 42-year-old woman with no family history of breast cancer: should she undergo mammography? Should prostatespecific antigen testing be performed in any but the highest-risk patients, given the high rate of falsepositive results and the harms of subsequent tests and treatments? All of these screening procedures, and others, have provoked controversy in recent years. In this era of evidence-based care, many clinicians and patients expect clear guidelines outlining what represents “best practices,” but a sharp divide exists when it comes to screening asymptomatic patients. Which screenings should be done, and in whom? Lung cancer provides a stark example; it’s by far the leading cause of cancer death in the United States, and some have hoped that screening with low-dose CT scanning might detect the disease at earlier, more treatable stages. Recently, supporters and opponents of this screening method have voiced their positions in an unusually public way. • In 2012, the American Lung Association recommended screening in long-term smokers, citing the National Lung Screening Trial (NLST), results of which suggested that the $300-to-$500 procedure “could reduce” lung cancer deaths by 20%, compared with X-ray (see http://bit.ly/1tu9xex). • Last December, the U.S. Preventive Services Task Force (USPSTF) cited the NLST in granting a “B” recommendation for the screening to be used in asymptomatic high-risk older smokers, indicating a “moderate certainty” that its benefits outweigh its harms (for the USPSTF analysis, go to http:// bit.ly/1cUEu8z). • In January, the American Academy of Family Physicians opposed the USPSTF (http://bit.ly/JYyZJI), issuing an “I” recommendation for the scans, concluding that there’s insufficient evidence to support their use in lung cancer screening and expressing “significant concern with basing such a far reaching and costly recommendation on a single study.” • In February, it was reported in JAMA Internal Medicine that 18% of cancers detected by CT scanning in the NLST were actually minimally invasive adenocarcinomas and that such “potentially clinically insignificant” cases likely resulted in “overdiagnosis”—in other words, inaccurate diagnoses of lung cancer and unnecessary invasive procedures. In April, the Medicare Evidence Development and Coverage Advisory Committee advised against Medicare coverage of this screening, saying the benefits don’t outweigh the harms (a final decision will be made next year). A bipartisan group of 42 U.S. senators has petitioned Centers for Medicare and Medicaid Services administrator Marilyn Tavenner to make the determination in favor of Medicare coverage for the screening—and to make it “expeditiously.” Complicating the argument are reports of a study suggesting that the procedure could cost billions of dollars per year and increase Medicare premiums by $3 to $9 per month (http://usat.ly/TcYknG). A close look at most recommendations on health screenings, including those supporting controversial AJN REPORTS

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssueArchivesePub Ahead-of-Print Collections Acute/Critical CareContinuing EducationCOVID-19 Disaster and Emergency PreparednessEnvironmental Health and IssuesEthics Evidence-Based Practice, Step by StepFamily CaregiversGeriatric NursingHolistic NursingIn The CommunityInfectious DiseaseInternational TopicsLegal ClinicMental HealthNurse WellbeingNursing Research, Step By StepNursing ResourcesPalliative CarePatient SafetyPolicy and PoliticsProfessional Development, Leadership and ScholarshipProfessional Partners Supporting Diverse Family Caregivers Across SettingsQI: Quality ImprovementResearchSocial Media and Information TechnologySpecial SupplementsStrip SavvySupporting Family Caregivers: No Longer Home AloneSystematic Reviews Step by StepTeaching For PracticeTransforming Care at the Bedside (TCAB)Uniforms (Nursing)Uniting States, Sharing StrategiesWomen's HealthWriting Resources Videos Videos WebinarsFor Authors Call for ManuscriptsSubmit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor Permissions Journal Info About the JournalAdvertising and BusinessAward WinnersBook of the Year AwardsContact InfoEditorial BoardInformation for FacultyInformation for MediaInformation for Peer ReviewersLetters to the EditorNurse Faculty Scholars / AJN Mentored Writing AwardOpen AccessReprintsRights and PermissionsSubscription ServicesNurses: Submit Your Photos! All Articles Images Videos Podcasts Blogs Advanced Search