Message to Authors: Think. Check. Submit.

October 5, 2015

By Maureen Shawn Kennedy, AJN editor-in-chief

Think. Check. Submit.

The above three words sum up the message of a new campaign to increase awareness among researchers and authors about predatory publishers—entities that take advantage of authors by unscrupulous practices that often leave the authors tied up in a contract and owing a large fee to publish in a journal that has little or no standing. (See my related editorial on predatory publishing in the April issue of AJN.)

Promising rapid publication, predatory journals lack peer review and fact-checking, often tout fake metrics, and may adopt names that are deceptively similar to those of established journals. Jeffrey Beall, a librarian at the University of Colorado, has been tracking predatory publishers since 2009 and maintains a list of them on his Web site, Scholarly Open Access.

The Think. Check. Submit. campaign describes itself as an “industry-wide initiative that provides a checklist of quality indicators that can help researchers identify if a journal is a trustworthy.” It’s a new campaign “produced with the support of a coalition from across scholarly communications in response to discussions about deceptive publishing.” In brief, it asks authors to:

THINK about where they should publish their work. Are the journals they are considering reputable?

CHECK the list of questions designed to help determine if a journal is respectable and sound.

SUBMIT . . . only if most of the criteria on the checklist are met. Read the rest of this entry »


Nursing and Social Media’s Limits: Real Change Requires Moving Beyond Hashtags and Selfies

October 2, 2015

Karen Roush, PhD, RN, is an assistant professor of nursing at Lehman College in the Bronx, New York, and founder of the Scholar’s Voice, which works to strengthen the voice of nursing through writing mentorship for nurses.

by rosmary/via Flickr

by rosmary/via Flickr

The recent #ShowMeYourStethoscope media campaign has been hailed as a powerful demonstration of the unified voice of nurses and what it can accomplish.

In case you’re not familiar with the incident that led to the outrage–after a Miss America contestant, Kelley Johnson (Miss Colorado), a registered nurse, delivered a monologue about her work for the talent portion of the yearly pageant while dressed in scrubs and wearing her stethoscope, hosts of the television show The View derided her, with one asking why she had on a “doctor’s stethoscope.”

There was soon a vigorous backlash across social media as nurses posted, blogged, and tweeted photos of themselves with stethoscopes, often adding moving descriptions of the situations where they use them or witty comments illustrating the absurdity of the hosts’ remarks.

I found it a heartening response to disrespect and ignorance. Nurses felt empowered and celebrated the opportunity to show the public what nursing is really about.

But has anything really changed? Yes, The View lost some sponsors and was forced to air an apology (albeit unconvincing and rather patronizing). And perhaps there was a brief uptick in nurses’ public image and visibility.

But does the public really now have any better idea of the complexity of nurses’ work and the richness of their contribution to health care? Will such a campaign have any impact on the issues facing the nursing profession, such as safe staffing ratios, barriers to independent advanced practice that hamper our ability to fulfill our role in primary care, or the lack of nurses in upper leadership roles in health-related organizations?

Preaching to the choir? Those of us who pay attention to social media outlets can easily get a skewed picture of the attention these viral campaigns generate. Though the incident and subsequent outrage were widely reported, particularly in entertainment and business media (because of the loss of advertisers), this alone is unlikely to create an impetus for systemic changes in health care on such issues as safe staffing ratios. Read the rest of this entry »


AJN in October: Ablation for A-Fib, Holistic Nursing, 50 Years of NPs, Care Coordination, More

September 30, 2015

AJN1015 Cover OnlineThis month’s cover celebrates AJN’s 115th anniversary with a collage of archival photographs and past covers. The images are intended to reflect the varied roles and responsibilities of nurses past and present, as well as to commemorate AJN‘s chronicling of nursing through the decades.

In this issue, we also celebrate another nursing milestone, the 50th anniversary of the NP, with a timeline (to view, click the PDF link at the landing page) that illustrates and recaps the significant progress made by this type of advanced practice nurse.

To read more about what has changed—and what hasn’t—for AJN and its readers after more than a century in print, see this month’s editorial, “Still the One: 115 and Going Strong.”

Some other articles of note in the October issue:

CE feature: Integrative Care: The Evolving Landscape in American Hospitals.” As the use of complementary and alternative medicine has surged in popularity in the United States, many hospitals have begun integrating complementary services and therapies to augment conventional medical care. This first article in a five-part series on holistic nursing provides an overview of some of the integrative care initiatives being introduced in U.S. hospitals and reports on findings from a survey of nursing leaders at hospitals that have implemented such programs.

CE feature: Catheter Ablation of Atrial Fibrillation.” This treatment for the most common sustained cardiac arrhythmia is a complex procedure. Although complications are rare and their incidence is decreasing, early recognition and appropriate nursing care can prevent an adverse event from spiraling into a major complication. This article gives an overview of the procedure, its possible complications, and best practices for nursing care.

Special feature: Intergenerational Lessons and ‘Fabulous Stories.’” While directing the Future of Nursing: Campaign for Action, Sue Hassmiller, the Robert Wood Johnson Foundation’s senior adviser for nursing, realized the value that nursing history could bring to the campaign. With the help of two nurse historians, she decided to interview her mother, a 1947 graduate of the Bellevue Hospital School of Nursing, in order to understand the changes that had occurred in the nursing profession during the 20th century—and was also interviewed herself. This article shares five lessons that Hassmiller learned in the process. Read the rest of this entry »


The Afterlife of Trauma, Near and Far

September 28, 2015

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

Mixed media illustration by Julianna Paradisi

Mixed media illustration by Julianna Paradisi

The alarm clock rang noisily. I wasn’t ready to surrender the cozy cocoon of my bed and venture into the emotional turbulence of this particular day: The 14th anniversary of 9/11.

The week leading up to it was rough. My stepfather had quadruple coronary bypass surgery in another city. Although it was successful, and his children were there to help and support my mother, I’ve felt guilty for not being there myself, because I’m the nurse in the family, and I feel responsible for every medical problem that arises for the ones I love—even if I’m not really needed.

Besides this, at work we’re in one of those cycles where every patient gets bad news: The cancer has invaded the borders of another organ, or the patient is incredibly young for the diagnosis that’s been received. Six months into my career as an oncology nurse navigator, I realize the emotional toll from secondary trauma is often more related to a previous job as a pediatric intensive care nurse than that of my more recent position as an oncology infusion nurse.

Because of all this, I decided to minimize my media exposure to the trauma of 9/11 this year. I stayed off of Facebook, and instead of watching the morning news I listened to Lyle Lovett croon the delightfully absurd lyric, “Penguins are so sensitive to my needs.”

It almost worked, but I share an office with a colleague who lived in the New York area at the time of the attacks. When she brought up 9/11, I asked her about it; she told me her experience, and my heart broke open. Then I told her how in 2001, here in Portland, Oregon, we watched the horror on TV with the rest of the world. But I also worked in an office at a hospital, where a colleague started a flurry of emails, explaining that her friends’ son worked in Two World Trade Center and was missing. His father had seen the first tower attacked on TV. He called his son, who answered the phone from his work cubicle, unaware of the disaster outside.

“Get out of the building, it’s not safe,” his father ordered. “Get out now!” He hung up, and that was the last he’d heard from his son. My colleague’s emails asked for prayers and positive energy for her friends and their son.

Late in the afternoon, we learned that her friends’ son had called. He’d escaped before the second tower was attacked. Because of his father’s warning, he had persuaded the other people in his department to flee with him. All of them were safe.

In telling the story, the emotion from 14 years ago flooded forward, as fresh and raw as it was back then.

My colleague and I talked some more, until our words were spent. Then we went to work contacting cancer patients, helping them through their personal crises.

At the end of the day, I felt weary, empty.

On my way home, I saw a tall, thin man, more hippie than hipster, walking down the street. His stork-like gait and mid-back-length ponytail caught my eye, but it was the bouquet of flowers he carried that held my imagination. He was bringing someone flowers: a visual expression of love on this day of sorrow.

It was only a small gesture, but it reminded me why I’m a nurse.

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Reflective Writing as a Crucial Counterweight to Clinical Experience

September 25, 2015

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

Kevin V. Pxl/Flickr

Kevin V. Pxl/Flickr

When I first started working as a nurse, I didn’t write much. My shifts, twelve hours of chaos, weren’t stories to be told, just days to survive. I wrote only when, after a traumatic event surrounding a patient’s death, I felt like I didn’t know who I could talk to about it. I had always written in a journal, but I hadn’t really thought of writing as a tool for healing—I just knew that I felt better after banging on the keyboard a bit.

Other than this single instance, I didn’t make writing a regular practice during my first year of nursing—a choice I still regret. I covet all of those forgotten lessons, missed descriptors, and stories that I might use in my writing now, but mostly, I wish I had known that moving my pen on a piece of paper might’ve helped me heal from the consistent stress of my new work.

A few years ago, by then a relatively experienced ICU nurse as well as a graduate student, I took a class called, “Writing, Communication, & Healing.” Taught by a poet and health care journalist, Joy Jacobson, it came at a time when I needed to learn how to write—for me, that is. I wrote for professors and for blogs; I even scribbled in a journal before sleeping each night. But during that semester I learned—in both practical and theoretical terms—the benefits of writing for my own healing through a technique called reflective, or expressive, writing. Read the rest of this entry »


Nursing Ethics: Helping Out on the Unit vs. Teaching Nursing Students Crucial Skills

September 23, 2015

By Jacob Molyneux, AJN senior editor

scalesJust as no two hospital units are exactly alike, rarely are two ethical conflicts exactly alike. There are too many variables, too many human and situational differences. This month’s Ethical Issues column, “Teaching Crucial Knowledge vs. Helping Out on the Unit,” explores potential ethical and practical issues faced by a clinical instructor who must balance the duty to teach essential skills to nursing students against the staff’s need for help in meeting patient care needs.

Will there be an easy, cut-and-dried answer? Probably not. In the course of their analysis of a hypothetical scenario, the authors make the following point:

Because new situations arise all the time, and every situation varies in its ethically relevant aspects, rigid rules often cannot guide ethical action. Instead, analytic skills and transparent negotiation are crucial for resolving conflicts between values as they arise in day-to-day interaction—and for supporting the solutions we choose.

While people skills may be as important as abstract ethical analysis in dealing with real world situations, determining which ethical principles or priorities are coming into conflict may provide us with a certain measure of clarity in our approach. The authors frame the conflict described in the article in the following way:

Read the rest of this entry »


Unexplained Deathbed Phenomena: Honoring Patient and Family Experience

September 21, 2015

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

by luke andrew scowen/flickr creative commons

luke andrew scowen/flickr creative commons

When my dad died, a special little travel clock that he’d given me years before stopped working. It restarted a week after his death, and continued running for years. I have no explanation for this sudden lapse in timekeeping, but it made me feel closer to my dad.

I’ve heard many other stories of unusual events surrounding the death of a loved one. I was therefore delighted to read this month’s Viewpoint column, “Letting Patients and Families Interpret Deathbed Phenomena for Themselves.” In this short essay, Scott Janssen presents some intriguing research findings and a compassionate argument for speaking openly about these occurrences. He writes:

“It’s an open secret among those of us working with the dying – there’s a lot of strange stuff going on for patients, as well as for the clinicians and family members who care for them, that rarely if ever gets talked about: near-death experiences, synchronistic coincidences (stopped clocks at time of death, for example), out-of-body experiences, and visitations from deceased loved ones.”

Janssen, a former hospice social worker and now a psychotherapist, sees such phenomena as part of “the normal continuum of experiences at the end of life.” He calls upon clinicians to create safe contexts in which patients and families can share these experiences without fear that they will be judged, ridiculed, or dismissed by caregivers.

It’s food for thought in the midst of our high-tech workplaces and death-denying culture. Read the rest of the article in this month’s AJN.

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