Doing the Doctoring–A Nurse Who’s Filling the Primary Care Gap for Needy Children

By Peggy McDaniel, BSN, RN

A while back, a poll on the AJN Website asked if PhD-prepared nurses should be addressed as “doctor.” My answer was an emphatic “yes!” Janie, an old friend of mine, just graduated with her doctor of nursing practice (DNP) degree this past spring. She recently opened up her own clinic, serving kids as a primary health care provider in Portland, Oregon. She is the inspiration for my vote, but her chosen path isn’t easy.

Janie is filling a void in Portland that few providers are willing to address. She’s called Dr. Janie, and she well deserves the title. I have been a foster parent here in Oregon for the past few years. The kids that enter foster care often come from neglectful and/or abusive situations. These children can be hungry, fearful, wary, dirty, sad, and often confused and angry. They also deeply crave a sense of safety.

The state requires that these children be seen within 30 days of entering foster care. Getting them seen is a huge challenge. The requirement is, in theory, a great idea—these children often have multiple medical and psychosocial needs that have been neglected. But I couldn’t find a clinic in Portland that would take a “new patient” with welfare insurance within that time frame. It was often days or longer before I would find out basic information such as allergies about the children I was asked to care for. As a nurse, I found this lack of information to be unsettling, […]

What Lies Ahead? AACN Presidents Weigh In on Health Care Reform, Rapid Response Teams, and More

By Shawn Kennedy, AJN interim editor-in-chief

On my last day at the American Association of Critical-Care Nurses’ annual meeting last week in Washington, DC, I had a chance to speak with both Beth Hammer, whose term as president ended with the meeting, and Kristine Peterson, the new president. Our conversation ranged from how they felt about being president of such a large nursing organization to their views on health care reform and how rapid response teams are affecting the work environment of critical care nurses. You can hear the conversation free on AJN’s Web site: go to the Podcasts tab and click on Conversations. Or just click here (the download may take a minute or two).

And don’t miss my first post from the exhibit hall floor at the meeting (the National Teaching Institute & Critical Care Exposition, or “the NTI”)  and my second post on a conversation with a critical care nurse about a bad staffing practice, which seems to have hit a nerve!

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Prospects for New Nurses: Thoughts on Graduating during a Downturn

By Christine Moffa, MS, RN, AJN clinical editor

Impending graduation is usually a happy, exciting time, especially for those who, after putting in years of hard work,  are finally about to get that college degree. In the mid-1990s I was in what I considered to be a pretty tough nursing program. For example, during my second semester of core classes we went from 30 students to 19; the drop-off was due to students failing out. Graduation couldn’t come fast enough.

However, when you find out that people who graduated one and two semesters before you are still looking for work, it can be a real buzz kill. That’s how it was for me in May 1995. During that time several hospitals were going through restructuring or reengineering (as this AJN article reported) and were replacing RNs with UAPs. It was next to impossible for a nurse without at least a year of recent experience to find a job in a hospital. Now, as a result of the recession, new graduates are  facing a similar situation. It took me almost a year to get my first job—and this was not without some sacrifices:  I had to relocate from New York to Miami and work the 12-hour night shift.

It ended up being worthwhile, but it was one of the hardest years of my life and potentially could have turned me off of nursing forever. Has anyone else out there had a similar experience? What […]

‘Go Home, Stay, Good Nurse’: Hospital Staffing Practices Suck the Life Out of Nurses

By Shawn Kennedy, AJN interim editor-in-chief

After I last wrote to you from the NTI (the American Association of Critical-Care Nurses’ annual National Teaching Institute and Critical Care Exposition), I headed back to the exhibit hall to check out the helicopter and the Army’s mobile operating tent. But I didn’t get to either one, because I met a young critical care nurse from a regional hospital in Missouri. We chatted about her workplace, and it was obvious that she was very proud of the work she and her colleagues did. When I asked her, “What’s your biggest issue?”, she said that it was probably staffing. I expected her to cite the shortage and the difficulty of finding qualified critical care nurses. But that wasn’t what she meant—rather she was talking about  bare-bones staffing because of tight budgets. Her hospital routinely switches between two tactics: it sends nurses home when the patient census is low (when this happens, the nurses are paid only $2 an hour to be on call, but must still use a vacation day to retain full-time benefits, a tactic that rapidly depletes their vacation time); or, when the patient census is higher, the hospital imposes mandatory overtime, creating havoc in nurses’ schedules, finances, and personal lives. And people wonder why there’s a nursing shortage! […]

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