An Unusual Privilege: A Patient’s Memorable Grace

Jonathan Peter Robb works as a district nurse for the National Health Service in London and has published two essays in AJN‘s Reflections column in recent years, “How I Built a Suit of Armor as a Nurse (and Stayed Human)” and “Verification.”

I was working an evening shift and it was five o’clock when my mobile rang for a call-out. The patient was a woman I’d seen before, who’d been on and off our books for the past few years. She was old, and unwell, and when she last returned home, we were told she was dying. She had been made palliative. Her name was Ruth.

Even with her fluctuating health, Ruth remained incredibly sharp. She was also persistently positive. Ruth was the type of patient you could talk to and forget they were a patient. She asked me questions about myself. Despite the number of people I care for and my enquiries into their health and lives, it is a rare person who asks questions about my life.

I headed […]

2017-12-01T14:06:39-05:00December 1st, 2017|narratives, Nursing, nursing stories, Patients|3 Comments

A Public Health Nurse at the Intersection of Birth and Death

by Lisa Dietrich for AJN/ all rights reserved

The January Reflections essay in AJN is called “Touching Death, Touching Life.” The author, Yaffa Vinikoor, is a public health nurse who describes a patient she refers to as Sidney. Over time, she’s come to know the worn furniture of Sidney’s small apartment and the details of his life, such as Arnold, his paid caretaker, and Sidney’s younger wife, who lives separately. Sid has dementia and several other conditions and is in decline. “Sid,” she writes “usually lay slanted, like he’d been haphazardly dropped onto the enormous mattress, hair askew and face contorted.”

The essay explores what it’s like to be pregnant while doing such work. Vinikoor’s situation that summer puts her in relation to two very different currents:

I continued to do my work in the city as a public health nurse with the chronically ill homebound up until the day I went into labor. . . . I continued to walk miles per day, the nursing supplies in my backpack bowing my back and the baby in my belly guiding me forward . . . . As I cared for those whose lives were in steady decline, I thought about what giving birth to new life would […]

AJN’s August Issue: Positive Deviance, Vital Sign Alert Systems, Using Focus Groups, Teaching Nursing Abroad, More

AJN0813.Cover.OnlineAJN‘s August issue is now available on our Web site. Here’s a selection of what not to miss.

Sometimes rules are meant to be broken in order to serve the greater good. This month’s CE feature “Exploring the Concept and Use of Positive Deviance in Nursingaims to increase our understanding of positive deviance (“an intentional act of breaking the rules in order to serve the greater good”) within the context of nursing practice. You can earn 2.5 CE credits with this article. If you’re reading AJN on your iPad, you can listen to a podcast interview with the author by clicking on the podcast icon on the first page of the article. The podcast is also available on our Web site.

The early warning signs of deterioration that patients often exhibit several hours before cardiopulmonary arrest often go unrecognized by nurses. “Developing a Vital Sign Alert System describes an automated vital sign alert system that was designed to enhance patient monitoring without increasing the nurse’s workload. Earn 2.4 CE credits by reading this article and taking the test that follows it.

“Using Focus Groups to Inform Innovative Approaches to Care,” an article in our Professional Development department, uses case studies to describe how nurses can use patient focus groups for gathering qualitative data that can advance patient advocacy.

And if you are interested in what’s going on in the nursing world in other countries, read this month’s […]

Amazing and Disheartening: How We Continue to Fail Family Caregivers

By Shawn Kennedy, AJN interim editor-in-chief

Recently, as part of an ongoing collaborative initiative on supporting family caregivers with AARP (see the comprehensive, and free, AJN supplement called State of the Science: Professional Partners Supporting Family Caregivers), I listened to a group of family caregivers talk about what it’s like to care for sick parents and relatives at home. 

Most of the caregivers were in their 60s and retired, and now found themselves doing the back-breaking work of being on call 24/7, attending to everything from bathing and feeding to chauffeuring to health care appointments, paying the bills, and running the household—sometimes two households, if they lived apart from the person for whom they provided care.

It was amazing and disheartening to listen to them—amazing in terms of the lengths they went to make sure they were doing the right things, and disheartening because they were mostly on their own, with little support from the health care system. And this was right from the start; all said that information to prepare for the transition from hospital to home had been lacking. For the most part, families looked to the family physician to answer questions about what they would need to do at home—nurses were hardly mentioned.

What They Said

Bring Back the House Call

But what about those who are not quite frail but are homebound due to less serious health problems? If not for the home visit, the condition of the patient described above would have declined to the point of requiring an ER visit or hospitalization. As the blogger KevinMD points out, “In-home visits could take the place of unnecessary and costly hospital stays and help prevent equally expensive re-admissions to the hospital.” Maybe it's time to bring back the house call.

2016-11-21T13:21:41-05:00October 16th, 2009|Nursing|2 Comments
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