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Saturday, January 23, 2021
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Figuring out what works

Patient Care   Self-Care  Sleep

Today’s Read: 3 minutes

Understanding what people want, what your body needs, and what you respond to will help you be successful in nursing and in life. Today we discuss advance care planning, why rest cannot make up for sleep, and why mindfulness isn’t for everyone.

Do you know what is for everyone? The Daily Huddle! Tell your friends and colleagues about it. If they subscribe, you get presents. Yay! See details below.

MORNING BRIEF

Nurses help promote advanced care planning conversations

When left to their own devices, physicians discuss advanced care with their patients 3.7% of the time. However, when a nurse navigator spoke with patients about the topic prior to their wellness visit, advanced care planning was documented in electronic health records 42% of the time, according to a recent study in JAMA Internal Medicine.

The year-long, randomized effectiveness trial enrolled 759 patients, age 65 or older, with multiple chronic conditions and cognitive or physical impairments or frailty. The volunteers were randomized to either a nurse navigator-led group or a standard care group.

In the nurse-led group, a trained nurse navigator called the study participants before their annual wellness visit to explain advance care planning and to suggest topics to discuss with their doctor during the clinic visit. That information then was recorded in the doctor’s notes to provide a starting point for the conversation. Both patients and providers reported that this priming often made the visits go much more smoothly and achieved the intended result. Interestingly, 26% of participants only wanted to have those advanced care planning conversations from their nurses instead of their physicians.

Luckily, this approach to advanced care planning is potentially scalable in the ambulatory care setting.

Rest cannot take the place of sleep

When it comes to performing your best, you need sleep. Recent research has highlighted the dual functionality that sleep has: Unused connections are weakened, and relevant connections are strengthening. Resting in a dark room doesn’t provide the same benefit.

Specifically, researchers conclude in SLEEP that sleep is irreplaceable for the recovery of the brain, which cannot be replaced by periods of rest for improved performance. The state of the brain during sleep is unique. Make sure that you give your brain the ability to recover and use these science-backed strategies to help you sleep better tonight.

It’s okay if mindfulness isn’t your thing

We talk a lot about being mindful and how it can help you be more resilient as well as less anxious and depressed, but that isn’t always the case says University of Cambridge researchers. They found that mindfulness may be no better than other practices aimed at improving mental health and wellbeing.

Just to jog your memory: mindfulness is ‘the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment’. 

Researchers analyzed 136 random controlled trials and found that in most community settings, mindfulness reduces anxiety, depression and stress, and increases wellbeing compared to doing nothing. However, the data suggested that in more than one in 20 trials, mindfulness-based programs may not improve anxiety and depression.

These programs’ success can be influenced by how, where, by whom they are implemented, and for whom they are targeted. And while mindfulness is often better than taking no action, researchers found that there may be other effective ways of improving our mental health and wellbeing, such as exercise. The good news is that there are many options; the key is finding the one that works for you.

ONE BIG NUMBER

57.6%

The percentage of adults aged 20 years or older who have taken a dietary supplement within the past 30 days, according to the CDC MMWR. This points to the importance of asking patients about if they are consuming anything—supplements, vitamins, minerals, etc.—daily.

DAILY DIVERSION

Who knew that kitties liked cabbage?

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