Archive for the ‘patient perspective’ Category

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Early Localized Prostate Cancer: Nurses Can Help Men Weigh Diagnostic, Treatment Options

March 18, 2015

By Jacob Molyneux, AJN senior editor

A new diagnosis of prostate cancer can be daunting. Nurses play an increasingly important role in helping men and their partners find their way through the maze of available information and choices. One of the two March CE feature articles in AJN, “Early Localized Prostate Cancer,” gives a thorough overview of tests and treatments.

The author, Anne Katz, is a certified sexuality counselor at CancerCare Manitoba, a clinical nurse specialist at the Manitoba Prostate Centre, and a faculty member in the College of Nursing at the University of Manitoba, Winnipeg, Canada, and Athabasca University, Alberta, Canada. She is also the editor of Oncology Nursing Forum. Writes Katz:

. . . as many as 233,000 men in the United States are diagnosed with prostate cancer each year, 60% of whom are ages 65 or older. Most diagnoses are low grade and localized . . . . Since low-grade, localized prostate cancer is slow growing and rarely lethal, even in the absence of intervention, it can be difficult for men to make treatment decisions after diagnosis—particularly if they do not understand the nuanced pathology results they receive and the potential for treatment to result in long-term adverse effects that can profoundly affect quality of life.

Pros_Cons_PSA_ScreeningThe article discusses options for intervention, potential adverse effects associated with each option, and, crucially, the nurse’s “role in helping men and their partners navigate the challenges of making treatment decisions that are appropriate in their particular circumstances.”

Read the rest of this entry ?

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Telling the Truth, Keeping a Patient’s Trust

March 9, 2015

“Am I going to be okay?” Ami gasps. Her breath hitches, her chest rising and falling in spasms. One of my hands holds a mask to her face; the other hand holds hers. Pain has made her strong—my fingers are almost as white as her pale face, radiant with fear.

Illustration by McClain Moore for AJN.

Illustration by McClain Moore for AJN.

That’s the start of the Reflections essay in AJN‘s February issue, “Am I Going to Be Okay?” Nurses tell patients ‘it’s going to be okay’ because the words can keep them calm, because no one can tell the future, because it’s comforting to hear ritualized phrases from a caregiver—even when they’re not, strictly speaking, true.

But are there times when more honesty is desirable? The author of this short Reflections essay delves into one such situation where the patient needs, above all, to feel trust for her nurse. Read the rest of this entry ?

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Strong Nurse and Patient Voices On the Blogs This Week

February 20, 2015

By Jacob Molyneux, senior editor/blog editor

Photo by mezone, via Flickr.

Photo by mezone, via Flickr.

Here’s a short Friday list of recent smart, honest, informative blog posts by nurses, as well as a couple of interesting patient perspectives on prominent types of chronic illness and the ways they are talked about by the rest of us.

At Head Nurse, in “Yes…No. I’m Having Some Thoughts About BSNs,” an ADN-prepared nurse makes some familiar and some more surprising observations about the effects of the new policy of hiring mostly BSN-prepared nurses at her facility as it tries for Magnet status. For example, one of the effects she notes is “a massive drop-off in terms of the diversity of our nursing staff.” The move toward BSNs is obviously the trend in nursing, and is supported by research, but this doesn’t mean that there aren’t still two sides to the issue, or real unintended consequences to address as this change is gradually implemented.

At Hospice Diary, the blog of hospice nurse Amy Getter, there’s a post called “Hearts, Flowers, and Bucket Lists.” Reflecting on the imminent death of a patient, the author puts the popular notion of bucket lists into perspective:

“I think about some of the things I would still like to do in my life, and realize . . . . most of those wish-list items would be swept away in a moment, if I only had a little time this week. I would hug my kids harder and love more, and want to squeeze every last drop of time to put into my relationships that I will have to leave behind. “

Staying with the end-of-life theme for a moment longer, you’ll find at Pallimed, a very good hospice and palliative medicine blog, a new post with a to-do list that some of us or our loved ones really can’t put off until next month or next year: “10 Practical Things to Do When Diagnosed With a Serious Illness.”

Two consistently good nurse bloggers, both of whom have written for this blog or for the journal itself from time to time, happen to have reviews of books about aspects of nursing on their blogs this week. Read the rest of this entry ?

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A Little Levity to Ease the Family Caregiver’s Burden

February 2, 2015
Illustration by Hana Cisarova for AJN/All right reserved.

Illustration by Hana Cisarova for AJN/All right reserved.

According to the CDC, almost 21% of households in the U.S. are affected by family caregiving responsibilities. The pressures and costs of this unpaid labor of love have been well documented.

This month’s Reflections essay, “Swabbing Tubby,” is written from the family caregiver perspective rather than that of a nurse. It’s about the wife and two adult daughters of an ailing older man as they are coached in one of the skills they will need to care for him at home.

It’s a tough situation, but one in this case leavened by the ability of these three women to laugh a little at the more absurd aspects of their predicament. Here’s the beginning:

In retrospect, I can’t help feeling sorry for the earnest young woman who tried so hard to show my mother, my sister, and myself how to hook up our brand-new, at-home, IV feeding device. She was all of 25, with the freshly scrubbed look of a young schoolgirl. Her youthful perkiness was no match for the trio of exhausted, crabby women who faced her across the empty hospital bed. Dad was down in X-ray having yet another CT scan, and the three of us were awaiting instructions on do-it-yourself intravenous feeding.

It’s not that they don’t take what they’re doing seriously or appreciate the training they are being given, or care for their suffering husband or father. But nurses know as well as anyone that resilience in the face of round-the-clock responsibility for another’s health and comfort demands more than just strong will—humor can be a crucial tool of those with real staying power. Read the rest of this entry ?

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So You’re a Nurse With a Story to Tell…

January 30, 2015

Madeleine Mysko, MA, RN, coordinator of AJN’s monthly Reflections column, is a poet, novelist, and graduate of the Johns Hopkins Writing Seminars who has taught creative writing in Baltimore for many years.

karindalziel/ via Flickr Creative Commons

karindalziel/ via Flickr Creative Commons

Whenever I meet someone new who happens to be a nurse—in both clinical and social settings—I wait for the right moment to mention my work at AJN on the Reflections column. It’s not only that I’m proud of the column. It’s also that I’m forever on the lookout for that next submission—for a fresh, compelling story I just know is destined to shine (accompanied by a fabulous professional illustration) on the inside back page of AJN.

“I imagine you have a story or two to tell,” I’ll say to a nurse I’ve just met—which is the same thing I say, whenever I have the chance, to nurses I’ve known for years. I mean it sincerely; given the vantage point on humanity that our profession affords, I actually do believe that every nurse is carrying around material for a terrific story.

The response I usually get (along with a wry smile, the raising of eyebrows, or a short laugh) is, “Oh yes. I have stories.”

But then—even as I’m mentioning the Reflections author guidelines, even as I say warmly that we’re eager to read—I can sense the backing away.

“Sure,” the nurse will say. “I’ll check it out . . . but the thing is, I’m not exactly a writer.”

Photo by mezone, via Flickr.

Photo by mezone, via Flickr.

How to explain it?—how to explain that we aren’t so much looking for nurses who are good writers as we’re looking for essays well written by good nurses.

If you’re still with me in this scenario (and especially if you’re someone not exactly inclined to sit down before breakfast on your day off and pen a gem of an essay) maybe you could let me know what you think of this pitch: Read the rest of this entry ?

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