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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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On the Phone: Punctuation for a Parent’s Decline

August 15, 2014
Illustration by Elizabeth Sayles for AJN. All rights reserved.

Illustration by Elizabeth Sayles for AJN. All rights reserved.

“It’s ridiculous. I’m deciding the rest of my mother’s life based on research I did on the Internet,” I tell him.

“You’re really good at that. Research, I mean,” he says, hope in his voice.

I want to scream that I don’t think an undergraduate degree in biology and a long relationship with Google qualify me as a medical professional.

Many of us don’t use the phone as often as we used to, but there are times of strangeness and loss when it may still assume the central role it played in an earlier era. The passage above is from “On the Phone,” the August Reflections essay, which finds a novel way to talk about the strains and strangeness of finding oneself a family caregiver—the gradual withdrawal of a once vibrant parent (or spouse or sibling) from the home that had once seemed to be defined by their presence, the isolation, the learning curve when faced with medical emergencies and the need to make crucial decisions that can’t wait, the reliance on the advice and interventions of nurses and physicians.

All Reflections essays are free and can be read in just a few minutes. This month’s is about an experience, family caregiving, that more and more of us are having in one form or another, whether we find a way to tell about it or not.—Jacob Molyneux, AJN senior editor

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The Gaza Conflict, Through the Lens of Nursing

August 13, 2014

By Jacob Molyneux, AJN senior editor

In 2005, AJN published an article looking at the experiences of nurses in Israel and in the Palestinian territories (free until September 15; choose ‘full text’ or ‘PDF’ in upper-right of the article landing page). Here’s an excerpt:

“[N]urses in the region have many of the same problems American nurses have: disparate educational levels, struggles for professional recognition and workplace representation. The nurses I met came into the profession for diverse reasons and are working in a remarkable variety of settings, carrying on in the face of political, professional, economic, military, and personal difficulties. Yet I was amazed at the things these nurses have in common with each other—and with us. As I listened to them describe their motivations and aspirations and watched them work, the seemingly impenetrable barrier created by the ongoing military and political conflict melted away.”

Photos and captions from 2005 article about Palestinian and Israeli nurse. Courtesy of Constance Romilly.

Photos and captions from 2005 AJN article. Courtesy of Constance Romilly. Click to expand image.

The current conflict between Israel and those living in the Palestinian territories is another chapter in a long story. Our focus at AJN is not on the politics of the situation or the rhetoric of blame coming from supporters of both sides. Most of our readers already have opinions on the topic, and there are other, more appropriate places you can engage that argument.

The stress and suffering, deaths, injuries, and loss of infrastructure have been well documented. We see lots of images of bombed-out concrete buildings that seem always to have been ruins in some nameless place, with little evidence of the lives only recently played out there. Still, one at times stumbles upon photos of people caught in the shelling, the scarred, maimed, or dead lying in rows on stretchers. These are hard to look at or forget.

As has been noted by many international aid groups and the UN, the health care system in Gaza is under great strain and in urgent need of donations, with a number of hospitals destroyed and others without power or basic medical supplies. In shelters where many are seeking refuge from the bombing, the overcrowding and lack of adequate sanitation is giving rise to disease. A number of groups are mobilizing teams of surgeons and nurses to travel to Gaza and treat the wounded. Others are gathering medicines and medical supplies to send. Read the rest of this entry »

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Some Essential AJN Resources on Care of Older Adults, Family Caregivers, More

August 11, 2014

800px-Woman-typing-on-laptopBy Shawn Kennedy, AJN editor-in-chief

August is one of my favorite months. Many people take time off, so the commute into AJN‘s Manhattan office is fairly easy. People’s pace seems to be a little bit slower; there seems to be less immediacy around responses to email. It’s a good time to catch up on reading manuscripts and other work I’ve had piled up.

If you’ve gone through your beach reading, here are a few useful collections on perennially important topics from our back pages:

If you’re just getting started in a nursing career, you might want to read a three-part series of articles, “Protecting Your License,” written by AJN contributing editor Edie Brous, who is a nurse and an attorney and writes on legal matters for the journal. Her series describes common myths about licensure and what steps to take to protect yourself if you are sued or brought up on charges by your state board of nursing. Read the rest of this entry »

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