A Call to Address Fatigue to Protect Nurse Health and Patient Safety—from 1919

The evidence on nurse fatigue has been there all along.

During Women’s History Month, which is about to end, I’ve been posting (here and here) on nursing history (and in the process exploring its close confluence with women’s history). For this last post, I’m highlighting an article published in the March 1919 issue of AJN—exactly 100 years ago. The evidence on fatigue from long working hours has been there all along.

The Movement For Shorter Hours in Nurses’ Training Schools” (free until April 15; click on the pdf version in the upper right), was written by Isabel Stewart, who was professor and then director of the nursing program at Teachers College, Columbia University, and coauthor of the National League for Nursing Education (the forerunner of today’s National League for Nursing) Standard Curriculum for Schools of Nursing.

A call for 8-hour work days for nurses.

In this article, which is in some ways disturbingly relevant today, Isabel Stewart notes that major nursing organizations recently met and were seeking “to enlist the support of a great many influential organizations and the general public in establishing an eight-hour day and a fifty-two hour week for pupil nurses.” (As a reminder, hospital nursing staff at that time were mostly […]

Sleepless Nurses

“If I couldn’t even figure out what goes into my lunch box, how could I possibly have multitasked . . . on a busy unit?”

Awake for 40 hours.

Photo by Jeff Greenberg. The ImageWorks.

I recently had the disorienting experience of being awake for 40 hours. This had to do with a family member’s interminable emergency department visit, a 3 a.m. car breakdown, and a post-ED MRI and medical visit.

I’ve never been up for 40 hours in my life. I didn’t pull “all-nighters” in school before exams, and never worked longer than a double eighthour shift. Partying the night away wasn’t in my DNA. So this experience was strange and new, and something I pondered over for days afterward.

An ‘otherworldly’ state.

By the time I’d been up for 24 hours straight, I was operating at a level about two beats behind everyone around me. Physically, I felt a little off-balance, as though I might fall if I didn’t step carefully. My brain seemed mired in muck, and I found myself trying to recall what I knew about depleting bodily stores of ATP. Preparing to return to work around hour 26, I stared into my lunch box. I couldn’t remember what food I was supposed […]

2018-05-21T08:29:35-04:00May 21st, 2018|Nursing|4 Comments

Working a Shift with Theresa Brown

bookBy Maureen Shawn Kennedy, AJN editor-in-chief

Many of you may be familiar with Theresa Brown, nurse and author of Critical Care: A New Nurse Faces Death, Life, and Everything in Between, as well as a blogger for the New York Times. Brown also writes a quarterly column for AJN called What I’m Reading (her latest column, which will be free until August 15, is in the July issue). Her new book, The Shift: One Nurse, Twelve Hours, Four Patients Lives, will come out in September, and I was able to read a prepublication copy. (You can pre-order it.)

I don’t usually write book reviews. I think of most books like food: what one person finds delicious may be less savory to another. But I’m making an exception because this book is an accurate and well-written portrayal of nursing (at last!).

Anyone who wants to know what it’s like to be a nurse in a hospital today should read this book. Patients, families, and non-nurse colleagues tend to see nurses as ever-present yet often in the background, quietly moving from room to room, attending to patients, and distributing medications or charting at computers. But what they don’t understand about what nurses do is what Brown so deftly describes—the cognitive multitasking and constant reordering of priorities that occur in the course of one shift as Brown manages the needs of four very […]

Staffing and Long Shifts – Some Recent Coverage

By Shawn Kennedy, AJN editor-in-chief

by patchy patch, via flickr by patchy patch, via flickr

The March issue will soon be published and be featured on the home page of our Web site, so before the February issue is relegated to the archive section, I want to highlight two articles. Knowing that some readers of this blog may not be regular readers of AJN (I know, hard to believe), I wanted to bring them to your attention.

I don’t usually blog about my own editorials, but the February editorial (“It All Comes Back to Staffing”) has apparently resonated with many readers. I’ve received several letters and a request to reprint it from a state nursing association. (The editorial includes a portion of a poignant letter I received from a reader in response to an editorial I’d written for the December 2013 issue, “Straight Talk About Nursing,” in which I discussed missed care—that is, the nursing care that we don’t get to but is often at the heart of individualizing care.)

The February editorial ties in with a special report, “Can a Nurse Be Worked to Death?”, by Roxanne Nelson from Van Insurance, which addresses the recent death of a nurse who was killed in a car accident while driving home […]

Top 10 New AJN Posts of 2012

British Nurse and Baby, via Flickr/jdlasica British Nurse and Baby, via Flickr/jdlasica

By Jacob Molyneux, AJN senior editor/blog editor

Maybe, who knows, some social media content isn’t really quite as ephemeral as we usually believe. Some of our posts seem to keep finding readers, like 2009’s “New Nurses Face Reality Shock in Hospitals–So What Else Is New?” They’re still relevant and timely, addressing as they do some of the more perennial topics in nursing.

Our 20 most-read posts for the year include several others that aren’t “new” this year: “Parting Thoughts: 10 Lessons Learned from Florence Nightingale’s Life”; “Confused About the Charge Nurse Role? You’re Not Alone”; “‘Go Home, Stay, Good Nurse’: Hospital Staffing Practices Suck the Life Out of Nurses”; “Is the Florence Nightingale Pledge in Need of a Makeover?”; “Do Male Nurses Face Reverse Sexism?”; “Fecal Impaction and Dementia: Knowing What to Look for Could Save Lives”; “Are Nursing Strikes Ethical? New Research Raises the Stakes”; and “One Take on the Top 10 Issues Facing Nursing.”

The upstarts. Putting aside posts that have shown a certain longevity, here are the top 10 new posts of 2012, according to our readers, in case you missed them along the way. Are they our best posts of 2012? We will leave that to you. Thanks to everyone who wrote, read, and commented on this blog over the past year.

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