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Family initiated rapid response team

After reading the article “Family initiated rapid response team (FIRR)” by Ehrig S., Hepburn, J., Riley, P., and Smolen, A., in the American Nurse Today August 2013 issue, I believe FIRR only emphasizes what a wonderful idea that FIRR is and how it can improve patient outcomes. A patient’s family members know the patient the best and are usually the first to notice small cognitive changes in the patient. The article proves as healthcare providers we need to listen to what the family has to say despite what test results show like in Josie’s and Lewis’s cases discussed in the article. Josie’s and Lewis’s parents knew something was wrong and expressed their concerns despite what healthcare providers told them. If only FIRR would have been established at the hospitals then, maybe those two young lives could have been saved.

Establishing a FIRR team can save lives and reemphasizes that we need to really listen to what the families have to say. I am sure it makes families feel a greater sense of involvement in their loved ones health. I believe the key to FIRR success is to make sure the patient and their families are educated from the moment they are admitted to the hospital, clearing up any misconceptions patients and families might have about FIRR and explaining the differences between an emergency and a nonemergency.

I would like to thank the authors for writing this wonderful and informative article.

Paige Thompson, RN

Garner, North Carolina

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Resilience: Live, love, laugh

I am delighted by the American Nurses’ Association’s leadership and commitment to improve the health of nurses. At Phillips Beth Israel School of Nursing, we have taken the advice of Suzy Harrington (author of Resilience: Live, love laugh, September 2013), and transformed her recommendations and those of other contributors into an action plan. We have implemented “Your Health First” at our school. The elements of this program address diet, exercise, rest and vaccination. A wristband with those exact words on them has become a part of the students’ uniform. The purpose of the wristband is to remind students to address those issues both personally and with every patient under their care.

We have in a very real fashion made changes at the school.

Diet: From day 1 of orientation, we start with fresh fruit rather than pastries. No soda is sold in the school’s vending machines and the snacks sold are nutritious. Our school has become a no-donut-zone, which we enforce as best as we possibly can.

Exercise: Jump ropes and hula-hoops hang in the hallways of the school (and in the administrative suite) for a quick exercise between classes, a trainer holds weekly exercise sessions, and a walking team has been started.

Rest(ore): Although rest is often in short supply during a nursing program, weekly yoga sessions and our dedicated meditation room are a beginning step to address the stress students face.

Vaccinations: All students at the school are required to get flu vaccinations annually. The only exception is an allergy to eggs and for those situations students must wear masks in clinical.

Our “Your Health First” logo is a serotonin molecule, which is an example of how biochemistry is in action at our school every day. We believe that our program will help to make our graduates healthier nurses who can teach patients by example and with knowledge.

The only recommendation that I can add is to explore the work of Steven M. Southwick and Dennis S. Charney. Their book, Resilience: The science of mastering life’s greatest challenges (2012, Cambridge University Press), provides additional insights from a scientific and psychological perspective. Dr. Charney’s “Resilience Prescription” supports and adds to the “Tips to bolster resilience” in your article. It is nice to know that our colleagues in medicine are with us in this journey to a healthier profession.

Janet Mackin, EdD, RN

Dean, Phillips Beth Israel School of Nursing
New York

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