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Labor Day Déjà Vu – Nurses’ Views of Work, Then and Now

September 2, 2014

By Maureen Shawn Kennedy, AJN editor-in-chief

Photo from otisarchives4, via Flickr.

Photo from otisarchives4, via Flickr.

If you like nursing history, there’s a new blog called Echoes and Evidence by the Barbara Bates Center for the Study of the History of Nursing at the University of Pennsylvania. (The first post draws on a 2005 AJN article on how nurses over 100 years ago responded to a series of typhoid epidemics in Philadelphia.)

Because AJN is over 100 years old (115 next year), it has a rich archive that I’ve been digging into recently (see my post from last week about an article Virginia Henderson wrote for AJN 50 years ago, and from late June, about nurses and D-Day).

So it seems especially fitting, just after Labor Day, to point to a January 1953 article by Sister Mary Barbara Ann, a former president of the Iowa Nurses Association (INA), which detailed findings from a survey of 223 general duty nurses in Iowa to learn their opinions of the hospitals in which they worked. I won’t present her exact findings here—we’ve made the article free until the end of September: just click through to the PDF. (Subscribers can always access the archives.) But here’s how she summarized what she learned:

“They [general duty nurses] are asking only for reasonable working conditions in which they can feel happy and secure. They are pleading for recognition and appreciation for what they are as persons and as nurses. They are asking for personnel policies which they have a voice in formulating, which are written and available to all, and which will be strictly adhered to by both nurses and administrators.”

Sound familiar?

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AJN’s September Issue: Anaphylaxis at School, Central Line Care, EBP, More

August 29, 2014

SeptemberAJN’s September issue is now available on our Web site. Here’s a selection of what not to miss.

It’s back-to-school time, and on our cover this month is a photo of Head Start nursing supervisor Travia Williams weighing a student in the program’s classroom at Cocoa High School in Brevard County, Florida. The program provides enrolled children with screening, physicals, and other health care services.

According to the National Association of School Nurses, a third of all school districts in the United States have reduced nursing staff and a quarter don’t have any nurses at all. Yet there is the potential for more emergencies in school now than ever, with school nurses treating increasingly complex medical conditions and chronic illnesses. For more on the important role school nurses play in handling these health emergencies, see the In Our Community article, “Emergency Anaphylaxis at School.” And don’t miss a podcast interview with the author (this and other podcasts are accessible via the Behind the Article page on our Web site or, if you’re in our iPad app, by tapping the icon on the first page of the article).

Applying EBP to Practice. Despite the recognized importance of evidence-based practice (EBP), there continues to be a gap between the emergence of research findings and their application to practice. In this month’s original research article, “Staff Nurses’ Use of Research to Facilitate Evidence-Based Practice,” the authors used an online survey to determine to what extent RNs in an acute care multihospital system used research findings in their practice. Several barriers to such use were revealed, including lack of time and resources. This CE feature offers 3 CE credits to those who take the test that follows the article. Read the rest of this entry »

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How Do You Define Nursing?

August 27, 2014

Virginia Henderson

Virginia Henderson

By Maureen Shawn Kennedy, AJN editor-in-chief

Fifty years ago this month, in the August issue of AJN, Virginia A. Henderson, one of nursing’s giants, explained how she came to her definition of nursing: “The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.” (We’ve made the article, “The Nature of Nursing,” free until September 30. Click through to the PDF under “Article Tools.”)

Many (older) nurses may remember Henderson as one of the authors of Harmer and Henderson’s The Principles and Practices of Nursing, a mainstay textbook for nursing schools, or for her internationally published book, Basic Principles of Nursing Care, which was translated widely. She also taught nursing at Teacher’s College, Columbia University, and then later at Yale University, where she developed a comprehensive index of nursing research. But her accomplishments went far beyond that. Her writings helped change how nursing was being regarded—from an occupation that existed only to provide physicians with helpmates to a scholarly, independent profession.

I had the good fortune to meet Henderson in the early 1990s, when she came to AJN’s offices to meet with Fred Pattison, AJN’s librarian at the time, who was also the editor of the International Nursing Index. She was warm, engaging, down-to-earth, and had a wonderful sense of humor—not what I expected from a legend! Her personality shines through in this video, shot in 1978 for a series on nursing leaders produced by Sigma Theta Tau International.

Her biography from her 1996 induction into the American Nurses Association’s Hall of Fame notes: “A modern legend in nursing, Virginia A. Henderson has earned the title ‘foremost nurse of the 20th century.’ Her contributions are compared to those of Florence Nightingale because of their far-reaching effects on the national and international nursing communities.”

(Subscribers to AJN have full access to AJN’s complete archives, chronicling 114 years of nursing—very worthwhile browsing!)

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Coincidental Violence Against a Nurse: More Prepared Than You Think?

August 25, 2014

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

The Myth of Closure/ oil stick and charcoal on paper 2014/ Julianna Paradisi

The Myth of Closure/ oil stick and charcoal on paper 2014/ Julianna Paradisi

Recently I was attacked by a stranger while running in the bright, mid-morning sunlight of summer through a populated urban setting.

My attacker did not know I am a nurse, so it’s only coincidental that it was violence against a nurse. However, I believe my nurse’s training contributed to choices I made in response.

How It Began: As I was running towards home through a busy recreational area along the river, a disheveled man on a bicycle turned a corner from the opposite direction and I swerved left to avoid collision. I thought nothing of it, and continued on.

First Contact: A few yards later, the same man rode closely up alongside of me so suddenly that I was startled when he angrily yelled something in gibberish. My nurse’s education and experience had schooled me not to react, not to make eye contact, and to get out of his personal space. At this point, the sidewalk forked. The stranger continued towards the left. I went right, on the greenway along the river. I kept running to put distance between us.

Second Contact: I felt him coming after me on his bicycle. I knew he was going to run me down. The nurse’s ability to critically think after a rapid assessment came to my aid. To the right was the river embankment lined with rocks. It wasn’t a long fall, but the loose rocks and the river held potential for further harm if he pursued. Instead, I chose to cross left, and then make my way up and through the landscaping of the riverfront condominiums. I didn’t succeed: he hit me from behind with his bike, yelling “Run faster!”

I knew it was important to stay on my feet, and throwing my weight backwards to stop the momentum, I did—grateful for an exercise class I’d started several weeks ago, strengthening my core. Read the rest of this entry »

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Essentials for New Clinical Nursing Instructors, Especially Adjuncts

August 22, 2014

There are many things it’s helpful to know when you start work as a clinical instructor—and you might not get a lot of orientation first.

By Maureen Shawn Kennedy, AJN editor-in-chief

“So you’ve accepted the contract for your first part-time clinical teaching assignment and you’re wondering where to start in preparing for this new role. Perhaps you’ve been working in an administrative role, away from direct caregiving. Maybe you’ve been active in bedside nursing but have no formal preparation in clinical teaching. If you take the time to prepare for your teaching assignment, you can confidently lead your students through a meaningful clinical experience.”

Clinical instructor Betsy Moorhouse (second from right) reviews the contents of a pediatric code cart with her nursing students at Miles Memorial Hospital in Damariscotta, Maine. Photo © Getty Images.

Clinical instructor Betsy Moorhouse (second from right) reviews the contents of a pediatric code cart with her nursing students at
Miles Memorial Hospital in Damariscotta, Maine. Photo © Getty Images.

So begins “Starting a Job as an Adjunct Clinical Instructor,” the second article in our quarterly column, Teaching for Practice (published in AJN‘s August issue, the article is free until the end of September).

When I was working as a clinical nurse specialist, I was also adjunct faculty for a local school of nursing, working with students in the acute care setting. Fortunately, I had taken an education minor in graduate school—otherwise, I would have felt lost when faced with setting objectives, planning pre- and postclinical conferences, and student evaluations. Read the rest of this entry »

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Blogging: As Many Voices as There Are Nurses

August 20, 2014

By Jacob Molyneux, AJN senior editor

Blogging - What Jolly Fun/Mike Licht, NotionsCapital.com, via Flickr Creative Commons

Blogging – What Jolly Fun/Mike Licht, NotionsCapital.com, via Flickr Creative Commons

A recent check reveals that a good percentage of the blogs on our nursing blogs list have been relatively active over the past few months. A few have been less so. I didn’t see any posts about the ice-bucket challenge, and that’s okay. Here are a few recent and semirecent posts by nurses that might interest readers of this blog:

Hospice nursing. At Hospice Diary, a post from a few weeks back is called “Dying with Your Boots On.” An excerpt:

As I drove down a switch-back gravel drive in the middle of nowhere, I pulled into a driveway and there in a sun-warmed grassy yard sitting perfectly still on a garden swing among buzzing bees and newly bloomed flowers was a fellow in a crisp white shirt, a matching white cowboy hat, black leather boots and a crooked smile.  I stepped out of my car and told him for a moment I thought he was the garden scarecrow, until he tipped his hat.

Nurse-midwifery. A post on At Your Cervix: Tales of a New CNM, First Year gives a short nuts-and-bolts glimpse of the author’s daily work life as a certified nurse-midwife. Those considering this specialty may benefit from one person’s experience of the pros and cons of one workplace:

I thought (as I was taught) that I would have more autonomy in practice . . . the two physicians are truly the “bosses.” Everything needs to be run by them . . . I definitely have more autonomy in the office setting. There was a big difference in reading/learning about prenatal care and GYN care, versus doing it. I didn’t learn (or have clinical experience in) nearly enough GYN clients! I think the number of GYN clients for clinicals was only about 35.

For the ‘research-minded nurse.’ At the INQRI blog—that is, the blog of the Interdisciplinary Nursing Quality Research Initiative, which has a stated goal “to generate, disseminate and translate research to understand how nurses contribute to and can improve the quality of patient care”—you will find even-handed and brief summaries of recent nursing research on topics such as the potential for hourly nursing rounds to improve patient care.

Renewal. If you’re taking a vacation and going somewhere more peaceful this summer, sometime AJN blogger Amanda Anderson has a contemplative post, “The Place Where Noise Becomes Sound,” at her blog This Nurse Wonders. It starts like this:

Summer has finally found me. Somewhere in the long train ride west, between naps and riders and minutes of staring at passing trees, I listened.

Read the rest of this entry »

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How Much Was Your Last Blood Test?

August 18, 2014

By Shawn Kennedy, AJN editor-in-chief

500px-Vraagteken.svgWe all know that prices for medical procedures often vary without rhyme or reason. But an article on Vox.com brought home just how ridiculous this price variation really is. The article describes the findings of a new study published in BMJOpen, the open access arm of the British Medical Journal.

The study evaluated costs charged for 10 common blood tests at more than 100 general acute-care California hospitals. Most were not-for-profit, urban, non-teaching hospitals with under 300 beds and an average of 25% Medicaid patients and 41% Medicare patients. The results were astounding:

“We found significant variation in charges for 10 common outpatient blood tests performed at California hospitals. For example, hospitals charged a median of US$214 for a basic metabolic panel, but the charges ranged from US$35 to US$7303. A lipid panel generated a median charge of US$220 at California hospitals, but the maximum charge of US$10, 169 was over a thousand times the minimum charge of US$10.”

It seems incredible: $10 vs. $10,000 for a lipid panel. As the authors conclude: Read the rest of this entry »

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