February Issue: Patient-to-Nurse Violence, The Future of Hospital at Home, More

“Workplace violence has become a familiar threat for those employed in a health care environment.”—Miranda Squire and Karen Hessler in this month’s Original Research article, “Patient-to-Nurse Violence During One-to-One Assignments: A Silent Epidemic”

The February issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

AJN Reports: What’s the Future of Hospital at Home in the United States?

Programs offering this promising acute care model have proliferated since 2020, but payment and regulatory structures to address equity, oversight, and sustainability are needed.

CE: Caring for Patients After Ileostomy Surgery

A review of postoperative care following ileostomy, including hydration, medication, and nutritional management.

Original Research: Patient-to-Nurse Violence During One-to-One Assignments: A Silent Epidemic

This qualitative cross-sectional study investigated workplace violence from the perspective of nurses and nursing assistants working one-to-one assignments who experienced violent encounters with patients or visitors.

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2023-01-30T09:10:36-05:00January 30th, 2023|Nursing|0 Comments

November Issue: Chronic Pain and Opioids, CVDs in Pregnancy, Preventing Patient Self-Harm, More

“[S]eeing this patient, his return, his presence, his enduring love, was a gift. Because some days in health care, you don’t really know what hope you are fighting for or for whom.”Hui-Wen (Alina) Sato, author of the November Reflections column, “Beholding the Returning Light”

The November issue of AJN is now live. Here’s what’s new:

CE: Implementing Guidelines for Treating Chronic Pain with Prescription Opioids

An overview of five tools outlined in the CDC’s 2016 opioid safety guideline—prescription opioid treatment agreements, urine drug screening, prescription drug monitoring program databases, calculation of morphine milligram equivalents, and naloxone kits—and their relevance to primary care nurses.

CE: Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy: A Clinical Review

The authors discuss three of the most common pregnancy-specific cardiovascular diseases and their risk factors, prevention, assessment, and management.
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2019-10-28T10:00:42-04:00October 28th, 2019|Nursing|0 Comments

‘So Many Things a Pill Can’t Solve’: An Integrative Therapy Nurse in Acute Care

“I don’t think that people realize how powerful human touch can be.”

“This therapy is invaluable to me—not just physically, but for my mental state too.”

“I think that we as Americans need more of this [integrative] therapy because there are so many things that a pill can’t solve.”

This is some of the feedback offered by patients after massage therapy sessions at the Minneapolis Veterans Affairs Medical Center. In this month’s AJN, integrative therapy nurse Hallie Boyd describes how her program has become a vital part of symptom management on the spinal cord injury and disorders unit there.

Help for patients in coping with chronic pain.

As a staff nurse on this unit, Boyd had encountered many patients who were trying to cope with chronic pain. While the hospital had long educated nurses on the use of integrative modalities such as guided imagery, acupressure, and aromatherapy, it was difficult for them to employ these techniques on a regular basis during busy and unpredictable shifts.

So, while continuing her work on the spinal cord unit, Boyd returned to school to focus on hospital-based therapeutic massage for medically complex patients. Training alongside a diverse group of practitioners, she developed and refined the idea of a full-time integrative therapy nurse as […]

2018-11-28T11:01:10-05:00November 28th, 2018|Nursing|1 Comment

Managing Your Patients’ Pain: It’s Not Just about the Opioids

Before Pain Assessment Was the Norm

Some of the most difficult times I experienced as a nurse involved patients in pain. This was before the days of patient-controlled analgesia, when patients in acute pain were mostly managed with “Demerol IM q4h.”

I recall many incidents of paging and telephoning and beeping physicians and residents to get orders for pain medications and trying whatever non-pharma methods I could think of to allay pain. It was awful to see patients suffer needlessly.

Progress, But with a Cost

Then pain became a key part of assessment, as well as of patient satisfaction scoring, and clinicians heeded the need for managing pain. However, there has been too much reliance on the quick fix of strong opioids. A friend who recently had surgery was asked by a nurse to rate his pain. When he replied “eight,” she asked him if he wanted one or two oxycodone pills. His reply, “Well, what do people usually take?”

Revising the Approach to Pain Management

Thankfully, pain management is being revisited, and along with a renewed focus on not prescribing by the numbers (a patient’s pain rating should only be one factor in deciding the intervention), there is a greater understanding of pain and how it can become chronic, and there are more modalities at our disposal to manage it.

To […]

Appropriate Use of Opioids in the Management of Chronic Pain

Painted by Martin Edwards as part of the Paint Your Pain program initiated by the Pain Management Center at Overlook Medical Center, Atlantic Health System, Summit, New Jersey. For artwork of other patients in the program, go to http://bit.ly/ 1Ns0PxL.The dangerous misuse of prescription opioids and drugs like heroin has been much in the news, but millions of patients continue to suffer both acute and chronic pain. For many, prescription opioids play a vital role in alleviating that pain. How can health care providers most effectively and safely use opioids in the treatment and management of chronic pain? Some answers can be found in a CE article in the July issue of AJN: “Appropriate Use of Opioids in Managing Chronic Pain.”

Related questions on opioids and chronic pain addressed in the article include:

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