Posts Tagged ‘Magnet hospital’

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Magnet Hospitals: It’s About the Process, Not the Designation

January 23, 2012

By Shawn Kennedy, AJN editor-in-chief

When I had a recent medical emergency, I went to the local community hospital near my home in northern New Jersey. I had been there before for outpatient testing or to the ER with a child and found the care attentive and efficient and the staff friendly and professional. Besides, it was a Magnet-designated hospital, so I was confident that I’d receive good care.

The ancillary staff was wonderful, but I found myself disappointed with the nurses on the acute med/surg unit where I was located. There was no rounding that I was aware of, and they seemed to only show up when it was time to administer meds. Only a few nurses introduced themselves, and only two nurses over three days really engaged me in any conversation. Nurses seemed to respond to call lights only for those patients to whom they were assigned. The unit clerk who promptly answered the call light intercom would say, “I’ll let your nurse know and she’ll be in soon”—when I asked for pain medication, she told me “your nurse is giving report; I’ll let her know when she’s finished.” I waited uncomfortably for more than half an hour.

There were whiteboards, but often the information—especially regarding the date and the name of the nurse—was unchanged from day to day and no longer accurate. (This was annoying, in that they kept asking me what date it was and I kept getting it wrong!)

The worst, though, was the noise level at night. I’ve worked nights, and I know it’s easy to forget to keep conversations hushed. But this unit was a good example of those that are as “noisy as chainsaws” (see our recent post on this). I was two doors down from the nurses’ station and I could hear every conversation, people singing holiday carols, detailed discussions of patients (forget HIPAA!). Requests that they reduce the noise made no difference. One night, I learned every detail about one nurse’s vacation plans while she and a colleague spoke in normal, conversational tones, occasionally laughing, while providing care to the elderly woman in the bed next to me at 2:30 am.

When I asked if they could speak a bit more quietly, one of the nurses angrily pulled back the curtain and told me that I had to understand that they needed to take care of the woman and would be done shortly. She then resumed talking about her vacation. I barely slept at all the three days I was there. It was exhausting, and I was happy to get home.

A few days later, I was admitted to a large teaching medical center in Manhattan, where I stayed for 10 days. The contrast was startling. The ICU nurses were incredibly attentive and supportive; they made me and my family feel that I was safe and in excellent hands. On the med/surg unit, the nurse manager introduced herself when I arrived. My assigned nurse for each shift would introduce herself and ask me if I needed anything; she came by frequently, even if only to poke her head in the room and say, “Everything OK?” Nursing assistants likewise introduced themselves and would inquire if I needed anything. Read the rest of this entry ?

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Nursing Is Hazardous to Our Health

June 4, 2010

By Shawn Kennedy, AJN interim editor-in-chief

Courtesy of the American Journal of Nursing archives

We all know that our nursing jobs expose us to various hazards—back and joint problems, needlesticks and other means of exposure to infectious diseases, traumatic injuries from encounters with violent patients or their family members, just to name some common ones. And as if that’s not enough, the psychological toll taken can result in burnout and even PTSD, which wreak havoc on retention. Heart disease and depression should probably also be on the list.

You may have seen news reports about a study with Danish nurses, published in the May issue of Occupational and Environmental Medicine. The researchers found that nurses younger than 51 years at baseline who perceived their workplaces as highly stressful were significantly more likely to have ischemic heart disease during the 15-year follow-up. Now, as the Journal of Clinical Psychiatry reports, a Finnish study has found that nurses and physicians who work in overcrowded acute care units have “twice the risk of sickness absence due to depressive disorders” compared with colleagues working in less crowded areas. And Health Policy reports on a study revealing that, among Canadian nurses, “Depression is a significant determinant of absenteeism for both RNs and LPNs.”

Is anyone surprised? Not nurses, for sure, and probably no one who’s worked at or been a patient in a hospital recently. With few exceptions, hospitals are generally terrible places to work. Yes, the Magnet Recognition Program and initiatives like Transforming Care at the Bedside (TCAB) and others are gradually improving this. (You can read more about TCAB in AJN’s special report and 12-part series.) But is it enough? Are nurses who experience job-related injury or illness the proverbial canaries in the coal mines, harbingers of an increasingly common and serious problem? What will it take for hospitals to revamp their environments to make them less stressful and more life-sustaining for nurses?

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