Archive for April, 2010

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To Isolate or Not To Isolate (and Other Hot Topics at the Epidemiology Conference)

April 13, 2010

By Rachel Zastrow, RN, BSN, patient safety liaison at Central DuPage Hospital, Winfield, Illinois

Back in March, thousands of infection preventionists and hospital epidemiologists (myself included) descended on Atlanta for the Society of Healthcare Epidemiology of America (SHEA) Decennial Conference. Over 3,500 professionals from 74 countries attended the conference. Despite the wide array of subjects, there were recurring themes that inspired intense emotion.

The topic that elicited the most audience participation involved the recommendation by the Centers for Disease Control and Prevention (CDC) to use N95 masks for worker protection from H1N1 patients. As many readers will know, the recommendation sparked a spike in demand that led to product shortages. The frustration of professionals in the room when the topic arose was palpable. Unfortunately, no consensus came from the conference, and the debate does not seem likely to disappear any time soon. A representative of the CDC defended the controversial recommendation.

AJN readers will remember the furor over mandatory influenza vaccination programs for health care facility employees. Although debate and even lawsuits hit both health care and mainstream news last fall, there was broad consensus among attendees regarding the need to improve vaccination rates in health care workers. Many participants expressed concern over the potential legal and organized labor ramifications of instituting mandatory programs.

Finally, the most interesting and unexpected debate came from a symposium Read the rest of this entry ?

Posted in H1N1 virus (swine flu), patient safety | Tagged , , , | Leave a Comment »

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What Matters to Today’s Nursing Students?

April 12, 2010

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

By Meagan/via Flickr

I just came back from the NSNA (National Student Nurses Association) convention in Orlando. What a crowd!  There were over 3,500 attendees, mostly nursing students and some faculty. And contrary to what one usually thinks of students on spring break, this group was serious and focused. Some impressions I took away from the meeting:

  • I was impressed with the many people pursuing nursing as a second career. I incorrectly thought several people I met were faculty because they looked older than many of the attendees—they were nursing students.  One had been a marketing executive, one a financial executive (for over 20 years!), one a regional manager of a cosmetics company, another a stay-at-home mom for 10 years . . . not to mention a bank teller who had been a caregiver for a family member who was quadriplegic. They had professional resumes; plans A, B, and C for job hunting; and were focused and organized.
  • Missing in the exhibit hall were hospital nurse recruiters. But presidents and representatives of nursing organizations were there, wooing potential new members either via booths or focus sessions. And with 80% of nurses not belonging to any professional association (according to Rebecca  Patton, president of the American Nurses Association, in her remarks to the group), associations need to figure out what would make these future nurses join their ranks.
  • Finding a job was the hot topic. I spoke with several students who were graduating next month or in December.  Most were having no luck; some couldn’t even get interviews because they had no experience. Those who had secured jobs seemed to have established an earlier relationship with the agency through an internship or working as a nursing technician or aide. Evetta Eubanks, an NSNA board of directors member from Kansas City, Missouri, told me that of her 63 classmates graduating next month, only eight others have secured jobs.
  • And as in other organizations, proceedings in the House of Delegates were sometimes contentious. Students from the Portland [Oregon] Community College chapter were angry at what they said was a planned move by the board of directors to defeat a resolution they had crafted.  Elizabeth McPhee, president of the chapter, said its resolution to gain the organization’s support to establish a full-time National Nurse was not given fair treatment. (See a 2009 AJN report on the controversy around the Office of the National Nurse, plus a more recent post here on the topic. The movement was buoyed earlier this year by legislation introduced by Oregon congressman Earl Blumenauer, H.R. 4601).

So if you attended the NSNA convention, what were your impressions?

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Posted in nursing students | Tagged , , , , | 1 Comment »

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Notes from the Nursosphere, Plus a Great Palliative Care Discussion

April 9, 2010

First: Twitter delivered a treasure this morning, from @abbrody (Ab Brody, an RN — and PhD — in San Francisco):

Wow,just wow! RT @DianeEMeier Pallimed:Post from husband of Dr. Pardi http://bit.ly/a3TH0X Do not miss this discussion! #hpm #palliative

What’s the big deal? Well, the New York Times ran a piece this week about Dr. Pardi, a palliative care doctor who fought it out against her cancer up to the end. The article was fascinating, disturbing, powerful, and we posted about it—and a related article we’d run in AJN not long ago—at this blog a few days ago.

What Brody’s Twitter message alerts us to today is an ensuing post and discussion at the palliative care blog Pallimed. The discussion has none of the harshness of tone one sometimes gets on Web discussions. Many of the people in the palliative care community seem to know each other, which always helps keep things civil (you don’t typically insult people you’re likely to meet in person).

A big question in the discussion is whether the Times story oversimplified the issues, creating an “either/or”  scenario out of something much more complex, and in the process made palliative care look like it’s all about convincing people to give up and die. But it really gets interesting when Dr. Pardi’s husband pops up in the comments section and attempts to clarify some of the questions and misperceptions raised by the Times story. You’ll have to scroll down below the Pallimed post to find it, but it’s well worth it.

Also this week, on the nursosphere: JParadisi has a thoughtful post that points out a certain jarring feeling she sometimes experiences when shifting between her work as a nurse and her work as an artist. Read it for the great list of things she did this week. And Change of Shift, the “nursing blog carnival,” went up on April Fool’s Day at the ambitiously named Millionaire Nurse Blog. It’s always worth a read.

Many blogs by nurses flower quickly and fade fast (several of the blogs on our blogroll have been silent for quite some time). Others pop up to take their places. Some endure, grow, prosper. Ecologists may soon undertake a study, but in the meantime A Nurse Practitioner’s View draws our attention to a few new or newish blogs by NPs and PAs. May they prosper. –Jacob Molyneux, senior editor/blog editor

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Posted in nursing perspective, pain control, palliative care, patient perspective, writing and nursing | Tagged , , | 5 Comments »

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To Address High Turnover Among New Nurses, A Virtual Training Tool With Real-Life Problems

April 8, 2010

(click image for larger version)

At this week’s National Student Nurses Association conference in Orlando, Johnson & Johnson’s Campaign for Nursing’s Future is unveiling a free virtual training program called Your Future in Nursing, which can be found at the Web site DiscoverNursing.com. (Sidenote: the site has many other resources for men in nursing, student nurses, and others, including a fairly vast collection of Profiles in Nursing, which is worth browsing through to get a sense of the really broad range of people who work in the nursing profession.)

You can download the virtual training program for free or order the CD through the DiscoverNursing.com Web site. Designed to address the extremely high turnover rates among first-year nurses who often feel woefully unprepared for the realities of the workplace, the program (full disclosure: we’ve watched a trailer, but we haven’t tried it yet ourselves) sounds intriguing (and a virtuous subsitute for a half hour spent on Facebook):

The interactive training tool allows nurses to select a 3D nurse character and navigate through the rooms of a virtual hospital. As they tour the hospital, nurses interact with animated versions of the people who will shape their first year on the job – hospital administrators, nurse managers, doctors, other nurses, patients and their families. Nurses work at their own pace to respond to different, real-life nursing scenarios they would normally encounter throughout the hospital. In addition to getting immediate feedback on each answer, sections close with a video message from an experienced nurse mentor who provides perspective and coaching on the new nurse’s experience. 

If you do give it a try, please (please!) let us know if you find it helpful.

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Posted in continuing education, nursing shortage, nursing students, practice tips, videos | Tagged , , | Leave a Comment »

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Nursing Handoffs: Do We Know What Constitutes Best Practice?

April 7, 2010

By Sylvia Foley, AJN senior editor

The patient in the next bed by mynameisharsha / Harsha K R, via Flickr

A systematic literature review on nursing handoffs, written by nurse researcher Lee Ann Riesenberg and colleagues and featured as a CE article this month, might just shock you. The researchers found that although there is  “abundant evidence that poor communication and variable procedures result in inadequate handoffs,” surprisingly little is known about what makes nursing handoffs effective. Which is kind of incredible, given how crucial handoffs are to providing safe and effective patient care.

Of the 95 English-language articles that met the researchers’ inclusion criteria, just 20 reported on research on nursing handoffs, and only 3 were found to be of reasonably good quality (scoring above 10 on a 16-point scale). The researchers concluded that although “the Joint Commission is calling for structured handoffs . . . we found very little evidence to support the use of any specific structure, protocol, or method.”

Barriers and Strategies
But the researchers were able to identify, categorize, and list numerous barriers to and strategies for handoffs that were mentioned in the literature. Read the rest of this entry ?

Posted in health information technology (HIT), nursing perspective, nursing research, patient safety | Tagged , , , | Leave a Comment »

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Taking A Stand Against Terminal Illness — Self-Delusion, or the ‘Good Fight’?

April 6, 2010

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

This week, The New York Times published an article about a young palliative care specialist who, when advised her cancer had progressed to the point where she should consider palliative care, rejected the notion and proceeded to pursue all available options. She was only 40 years old and said she was not ready to die. While the aggressive treatments (which she had plenty of money to pursue) gave her about another year, the article explains that her final days were spent heavily medicated for pain from the tumors throughout her body—even as she continued to request brutally painful procedures with little chance of prolonging her life.

That was her choice, and she knew what she was choosing. But that doesn’t always happen; too often, people really don’t know what it may cost them to take a stand against the inevitable. (For an engaging and comprehensive look at the issue and its implications for nurses, see Life Support Interventions at the End of Life: Unintended Consequences in the January issue of AJN.)

This month, AJN’s Reflections essay describes a scenario when full disclosure of the likely results of pursuing treatment wasn’t forthcoming from health providers. It tells of one nurse’s dilemma in balancing her role as family member and as a nurse during the last days of her mother-in-law’s terminal illness. At issue is how to explain to family members, who are “misinterpreting survival as recovery,” the likely outcome of aggressive treatments.

This piece struck home for me. As a chemotherapy nurse, all too often I witnessed patients with end-stage cancer wanting to undergo treatment that might promise, at most, a few additional months of life—but certainly not the life they’d had or wanted.  Read the rest of this entry ?

Posted in Uncategorized | Tagged , , , | 4 Comments »

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“The Next Time She Needs a Pap Smear at 3 AM . . . ”

April 2, 2010
Sunset, Turks and Caicos Islands

Sunset, Turks and Caicos Islands


By Christine Moffa, MS, RN-BC, AJN clinical editor

Vacations are an important part of keeping balanced in life and a good way to prevent career burnout. However, I’m sure that, like me, many of you have had to step out of relaxation mode to come to the aid of some unfortunate vacationer who either injured herself or himself trying a new activity, had a near drowning at the beach, or suffered some other tragedy.

I’ve just returned from a trip with six friends to Turks and Caicos. There was beach, sun, a lot of activities like snorkeling and the flying trapeze, and unlimited food and alcohol; in other words, it was the perfect set-up for a trip to the infirmary. (I once had a three-week nursing gig at a resort, so I know the usual ailments: overindulgence in food, alcohol, and sun; twisted ankles from people playing sports they haven’t attempted in the last 10 years; and the occasional serious accident or heart attack.)

Two days into the trip, one of my co-travelers fell ill with food poisoning, which resulted in a day’s worth of vomiting. At 2 a.m. my phone rang. It was this friend telling me that not only was she sick, but she’d just hit her head while running to the bathroom. Read the rest of this entry ?

Posted in nursing perspective, professional identity | Tagged , , , | 3 Comments »

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