UK: Huge Increase in Nurses Quitting Early in ‘Perfect Storm’ for Patient Care

The article is examining the increasingly rapid rise of nurses quitting the profession just 5 to 10 years after training. Because NHS staffing is a little different from the US systems, and for a much smaller population, there’s some direct applicability to what the United States is seeing in nursing, but probably in a more severe form. The analysis hits on money (later in the article), burnout, exhaustion, increasingly low staffing levels, increasing patient needs.

Like in the US, graduating more nurses is not going to be impactful if you can’t retain them. Canada is also experiencing the same problems, with 50% of nurses in some provinces leaving the profession before age 35.

UK: Huge Increase in Nurses Quitting Early in ‘Perfect Storm’ for Patient Care - Royal College of Nursing

QUIZ QUESTION

60 year-old female with painless non-pruritic rash

A 60-year-old female with a history of hypertension presents for evaluation of several months of a painless non-pruritic rash as well as  of the bilateral upper and lower extremities but no pain. (see Figures).

She notes no fevers, chills, night sweats or weight loss. No recent tick bites or recent respiratory/gastrointestinal infections or travel. She currently takes hydrochlorothiazide. She does not use tobacco products, alcohol or illicit drugs.

Blood pressure is 130/80, Pulse 75, respirations 14, oxygen saturation 99% on room air, Temperature 99F. General physical examination is within normal limits.

A picture of the rash is shown. Neurologic examination is remarkable for bilateral symmetric upper and lower extremity proximal muscle weakness and no distal muscle weakness. Sensation and reflexes are intact in all extremities.

Complete blood count, serum chemistries, and liver enzymes are within normal limits. CK is 4500 U/L, aldolase is elevated. TSH is normal. Erythrocyte sedimentation rate and C reactive protein are within normal limits.

What is the most likely diagnosis?

• polymyositis
• inclusion body myositis
• dermatomyositis
• polymyalgia rheumatica