Archive for the ‘professional identity’ Category

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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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AJN in February: Rapid Response Teams, Complications of CHD Repair, Managing Type 2 Diabetes, More

January 29, 2015

AJN0215 Cover OnlineAJN’s February issue is now available on our Web site. Here’s a selection of what not to miss.

Rapid response teams (RRTs) are teams of expert providers who can be called on in an emergency to treat patients before their condition deteriorates. The success of an RRT depends on whether it is activated properly, a task that often falls to staff nurses. The original research article, “Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis,” describes the factors affecting nurses’ decisions to activate RRTs. This CE feature offers 3 CE credits to those who take the test that follows the article.

Further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes).

Long-term complications after congenital heart defect (CHD) repair. Nurses often encounter patients with complications that occurred years after CHD repair. “Long-Term Outcomes After Repair of Congenital Heart Disease: Part 2” reviews four common CHDs, their repairs, common long-term outcomes, and implications for nurses in both cardiac and noncardiac settings. This article offers 2.5 CE credits to those who take the test that follows the article.

Making nurses full partners in reforming health care. The Institute of Medicine’s report, The Future of Nursing: Leading Change, Advancing Health, suggests that nurses should be full partners in reforming health care in this country. “A Bold New Vision for America’s Health Care System” is the first in a series that will revisit the report’s recommendations and the progress that has been made toward making them realities. Read the rest of this entry ?

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Nursing Perspective: Why I Work in Corrections

January 23, 2015

By Megen Duffy, BA, BSN, RN. Her blog is Not Nurse Ratched.

Michael Coghlan/Flickr

Michael Coghlan/Flickr

When I go to work, I go through a metal detector (did you know Danskos contain metal?), and all my belongings are scanned or gone through. I check out keys and a radio, and then I go through a series of sally ports to get to the medical area. I count every needle and pair of scissors I use. I never see patients without an armed guard nearby, and a good portion of my patients are cuffed and shackled. I’m on camera from the second I get out of my car.

Welcome to prison, nursing style!

“Why?” people ask me. “Couldn’t you get another job? Aren’t you scared? Didn’t you like the ER?” I worked in critical care/emergency nursing for a long time, and yes, I did like it. I brought those skills with me to corrections, where they are a lock-and-key fit. A surprising number of corrections nurses are ex-ER nurses. The same personality types work well in both settings.

Corrections nursing involves phenomenal nursing autonomy and uses many of the skills I honed in the ER:

  • quick triage
  • multitasking
  • sorting out who is lying from who is sick
  • knowing which assessments are the most important for each situation

The atmosphere tends to be quirky to chaotic and requires imagination, flexibility, and an ability to string together solutions to problems that no one has ever seen before. Particularly in jails, you never know what is going to come through the door. A jail booking area is exactly like ER triage.

I like that; I like having a job where strange things are bound to happen. I like seeing things that most people never see. I like knowing that things could get hairy at any time and that I have to be on my game all the time. Read the rest of this entry ?

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Calling All Nurses to Address Health Disparities

January 16, 2015

Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation and director of the Future of Nursing: Campaign for Action.

The author with nursing students at the Rhode Island Nurses Institute Middle College, the first charter school in the country for high school students who want to major in nursing.

The author with nursing students at the Rhode Island Nurses Institute Middle College, the first charter school in the country for high school students who want to major in nursing.

The research on health disparities is stark and continues to increase. The Centers for Disease Control and Prevention’s Health Disparities and Inequalities Report–2013 found that mortality rates from chronic illness, premature births, suicide, auto accidents, and drugs were all higher for certain minority populations.

But I believe passionately that nurses and other health professionals can be part of the solution to addressing these disparities. Nurses are privileged to enter into the lives of others in a very intimate way—lives that are often very different than our own.

I understand that it is human nature to be more comfortable with the familiar, but this is not what we are called to in nursing. More than 150 years ago, Florence Nightingale noted a strong link between a population’s health and its economic prosperity, and she called for all people to be treated equally.

My mother told me that when she first entered nurses’ training at New York City’s Bellevue Hospital School of Nursing in 1943, Director Blanche Edwards addressed the students on her conduct expectations for nurse trainees. Part of that lecture—and of the nursing culture absorbed by those being trained at Bellevue—addressed the equality of all human life and how she expected her nurses to treat everyone with equal care and attention. Read the rest of this entry ?

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‘Tables Turned': When the Patient’s Family Member Is a Nurse

January 7, 2015

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

Illustration by Eric Collins. All rights reserved.

Illustration by Eric Collins. All rights reserved.

Nurses are not always comfortable when a patient’s family member is also a nurse. In AJN’s January Reflections essay, “The Tables Turned,” a critical care nurse describes her attempt to navigate the role change from nurse to family member when her sister is hospitalized with multiple injuries after a bike accident.

Her sister is in obvious pain, but pain management is complicated by a low blood pressure. The author asks her sister’s nurse about alternative analgesics. She writes:

“The nurse, perhaps caught off guard by my question, answered abruptly: ‘I don’t think so. We don’t do that here.’ There was a pause. ‘Don’t do what?’ I asked. ‘We don’t do IV Tylenol,’ she repeated. She did not offer an explanation, an alternative, or say she’d ask another provider… I felt helpless, both as a critical care nurse and as a sister.”

As if to reinforce that the patient’s sister is not welcome to participate in care discussions, the charge nurse soon comes by and suggests that the author “step out to get some rest.”

Of course we don’t know the nurse’s side of the story; perhaps she had already fielded questions from many families that night. In stark contrast to the situation depicted in this essay, when my friend Stella was recently hospitalized after anaphylaxis and cardiac arrest, I was kept well-informed by a terrific team of critical care nurses. They treated me like a colleague, offering detailed updates about my friend’s progress and always listening to my concerns. I felt respected and supported, both as a nurse and as Stella’s friend. Read the rest of this entry ?

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Are Nurses Ready for Retirement? Apparently Not

January 5, 2015

By Shawn Kennedy, AJN editor-in-chief

Photo by Judy Schmidt/CDC

Photo by Judy Schmidt/CDC

If you ask many nurses in their sixties if they’re ready to retire, they may heartily say, “Yes, can’t wait.” But if the question is whether they are financially ready to retire, the answer may be quite different.

In their article in this month’s issue of AJN, “Preparing for Retirement in Uncertain Times” (free until the end of January), authors Shanna Keele and Patricia Alpert note that surveys reveal nurses to be unsure of how to begin preparing for retirement. A 2011 survey reported that “71% felt they were not saving enough for retirement”; another survey revealed that “59% of nurses do not know how to begin the retirement planning process” and most do not feel knowledgeable about investing and other related financial processes.

Keele and Alpert, who’ve conducted research around nurses’ readiness to retire, “explore the obstacles that nurses, especially female nurses, confront in planning and preparing for retirement. We outline steps nurses can take to begin the process; discuss various types of retirement accounts; and refer readers to helpful, free online resources.” There’s also a box that lists crucial steps to take if you’re getting a late start on retirement planning. Read the rest of this entry ?

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A Lasting Gift for a Nurse’s Holiday Shifts and Lost Family Time

December 19, 2014
Illustration by Lisa Dietrich for AJN.

Illustration by Lisa Dietrich for AJN.

As we know, gifts come in many forms, and often are as valuable to the giver as to the receiver. The best ones come at times when we least expect them. Readers will find that the start of AJN‘s December Reflections essay, “A Change of Heart,” describes a frustration that may be familiar to many nurses. In this case, it’s Christmas Day, and a nurse is kept by the urgent demands of her job from spending time with family. She writes:

I’ve been a nurse for more than half of my life . . . I love my career and consider myself blessed to have found my calling. But we all experience times when our long hours and the rigorous demands of this job make us feel that we sacrifice too much of our personal and family time to care for strangers.

The author had planned to be home for Christmas dinner. But, she tells us, “we had four back-to-back emergency CABGs starting at 8 am and stretching long past my scheduled 3 pm end of shift.” The essay develops from there as the hours pass. And then we meet a patient with everything at stake. The author is not the only one in danger of missing Christmas with family, and not just this year but for all the years to come.

We are reminded again and again that nursing has its truly redeeming moments of connection, those reminders that the work you do can be the difference between life and death for a patient. So it happens in this short, engaging essay. We encourage you to click the article title above and give it a read. It’s free, and it might put the various challenges of the holidays into perspective.—Jacob Molyneux, senior editor/blog editor 

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