Viewpoint: Some Arguments for More Autopsies

Detail from Rembrandt's 'The Anatomy Lecture of Dr. Nicolaes Tulp' Detail from Rembrandt’s ‘The Anatomy Lecture of Dr. Nicolaes Tulp’

When families ask whether they should get an autopsy, what will you tell them?

When I was a nursing student at the University of Michigan, we learned anatomy by working on human cadavers. The experience left me with a deep appreciation for the beauty of the human body (even when ravaged by disease) and fundamentally shaped my view of a nurse’s role in health and healing.

The Viewpoint essay in the August issue of AJN, “When Families Ask About an Autopsy,” reemphasizes the role of the human body as a teaching tool. Author Billie Holladay Skelley points out that autopsies can also

  • provide definitive answers about the cause of death (offering reassurance to family members).
  • reveal undiagnosed genetic conditions.
  • improve our understanding of diseases and disease trends.
  • and foster advances in treatment.

Virtual or minimally invasive autopsies may be more acceptable to some families while still offering some of the benefits of a full autopsy. […]

2016-11-21T13:01:01-05:00August 19th, 2016|Nursing|0 Comments
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The Debriefing: A Forced Pause After an Unexpected Clinical Loss

Illustration by Barbara Hranilovich for AJN Illustration by Barbara Hranilovich for AJN

The Reflections essay in the July issue of AJN is about the brief required debriefing of a medical team after an all-consuming struggle to save a patient.

“The Power of Paperwork” is written by Amanda Anderson, an experienced nurse who is new to a supervisory role. She remains closely attuned to the emotional experiences of nurses and physicians. Leading her former colleagues as they huddled to examine what might have been done differently with a particular patient, she tells us, she found that her “suit and heels provided no armor.”

Sometimes bad things happen for perfectly obvious reasons. If you don’t turn an incontinent patient, he will develop pressure ulcers. If you don’t always verify your patient’s medication against the order and identifiers, you will likely give the wrong drug to the wrong person at some point. The factors involved in such errors can be complex, of course, but remain fairly easy to trace.

Sometimes, though, people just die. We don’t know why, and if we find out, it’s usually not reassuring. The thoughts that follow these deaths—what if I… ?, should […]

2016-11-21T13:01:07-05:00June 27th, 2016|narratives, Nursing, nursing stories|0 Comments
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One Nurse’s Ode to Fragility

Illustration by Lisa Dietrich for AJN. Illustration by Lisa Dietrich for AJN.

For nurses, the world outside work may from time to time seem as fragile and tenuous as the health of patients. Natural disasters threaten homes, illnesses afflict family members, the reminders of impermanence become too insistent. This month’s Reflections essay, “The Robin,” explores such emotional terrain with sensitivity and honesty.

Gentle warning: This is not an essay that neatly delivers a pearl of take-home wisdom at the end. But that’s what we liked about it. Sometimes the best we can do is hang in there and pay close attention. And, if we’re able and willing, write about it. Here are the opening few paragraphs of this short essay: […]

2016-11-21T13:01:56-05:00October 7th, 2015|narratives, Nursing, nursing perspective|1 Comment
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The Afterlife of Trauma, Near and Far

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

Mixed media illustration by Julianna Paradisi Mixed media illustration by Julianna Paradisi

The alarm clock rang noisily. I wasn’t ready to surrender the cozy cocoon of my bed and venture into the emotional turbulence of this particular day: The 14th anniversary of 9/11.

The week leading up to it was rough. My stepfather had quadruple coronary bypass surgery in another city. Although it was successful, and his children were there to help and support my mother, I’ve felt guilty for not being there myself, because I’m the nurse in the family, and I feel responsible for every medical problem that arises for the ones I love—even if I’m not really needed.

Besides this, at work we’re in one of those cycles where every patient gets bad news: The cancer has invaded the borders of another organ, or the patient is incredibly young for the diagnosis that’s been received. Six months into my career as an oncology nurse navigator, I realize the emotional toll from secondary trauma is often more related to a previous job as a pediatric intensive care nurse than that of my more recent position as an oncology infusion nurse.

Because of all this, I decided to minimize my media exposure to the trauma of 9/11 this year. I stayed off of Facebook, and instead of watching the morning news I listened to Lyle Lovett croon the delightfully […]

2016-11-21T13:01:58-05:00September 28th, 2015|career, narratives, Nursing, nursing perspective, Patients|2 Comments
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‘An Immutably Personal Process’: A Hospice Nurse Contemplates Uncontrol

Megen Duffy, RN, BSN, CEN, currently works in hospice case management. She writes AJN’s iNurse column, which focuses on technology and nursing.

by mark ahsmann/ wikimedia commons by mark ahsmann/ wikimedia commons

I started my day the way I often do: watching sunlight begin to filter in and softly illuminate the sunken face of a person who would die, not later, but sooner. I sat curled in the chair I’d been in since 3:00 AM, wrapped in my sweater against the institutional chill, and waited.

This is, perhaps unbelievably, my favorite part of being a nurse. In hospice, there is no deadline. No one needs the room right now. The patient does not have to go to the floor in the next 30 minutes to avoid throughput delays. I do not have five other patients claiming my time. No, I have the gift of being able to sit quietly with only one objective: to do everything I can to make sure this person leaves this life without pain or fear.

I am not bored. It may appear as if I am doing nothing, but that is far from true. I am watching and listening for every breath, every movement, every toe that turns a deep bruised purple, every expression that may say “I am hurting.”

I am merely cooperating with death, and death’s agenda is never known to me. My job […]

2016-11-21T13:02:06-05:00August 27th, 2015|Ethics, narratives, Nursing, nursing perspective|8 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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