How Do You Feel When Your Patients Can’t Afford Care?

“Every day in the United States, nurses watch patients forgo beneficial treatment they cannot afford despite nursing’s moral standard to treat patients without regard to financial condition.”

How often have you been left, pretty much on your own, to figure out a way that your uninsured and/or homeless patients have access to something (anything!) that will maintain their health when you aren’t with them? Are there meds they can’t pay for? Do they need prenatal care that they can’t afford? Can they possibly function without home care of some kind?

Moral distress as a call to seek systemic change.

In “Ethical Issues: The Moral Distress of Nurses When Patients Forgo Treatment Because of Cost” in this month’s AJN (free to access until October 7), Douglas Olsen and Linda Keilman discuss the moral distress of nurses when we are unable to meet the needs of patients who don’t have the money to pay for care in our for-profit health care system. […]

September Issue Highlights: Discussing Gun Safety with Patients, Trauma-Related Hemorrhagic Shock, More

“It is abundantly clear from this pandemic that we are all connected and need the strength of nations working together to thwart any threat to global health and well-being. We ignore
our connectedness at our own peril.”Pamela F. Cipriano in her guest editorial, “Standing with the WHO”

The September issue of AJN is now live. Here are some highlights.

Original Research: Nurses’ Knowledge and Comfort with Assessing Inpatients’ Firearm Access and Providing Education on Safe Gun Storage

The authors sought to determine hospital nurses’ knowledge of firearm safety and current state law, and their comfort with asking patients about gun access and educating them on gun safety.

Trauma-Related Hemorrhagic Shock: A Clinical Review

This article discusses the general principles underlying the pathophysiology and clinical management of trauma-related hemorrhagic shock.

Special Feature: An Intimate Glimpse of Emergency Nurses at Work

A photo-essay featuring scenes from a new film by Carolyn Jones, In Case of Emergency, which profiles the daily lives of ED nurses across the country.

[…]

2020-09-01T08:51:36-04:00September 1st, 2020|Nursing|0 Comments

Preserving Integrity and Staying Power as a Nurse in a Pandemic

We are in unprecedented times—uncertainty and fear are ever present and nurses are being called to serve others in ways that challenge our appraisal of benefit to our patients and risk to our families’ health and well-being. Many of us are experiencing varying degrees of moral distress and moral outrage arising from the gaps between what we ought to be doing and what we are actually doing under these adverse conditions. It can feel as if it is impossible to do ‘the right thing.’

What can we do to remain whole in the midst of the COVID-19 crisis? How can we accept what seems unacceptable?

Instead of using precious energy in unproductive ways, we can focus on the things that are within our control for meeting the demands of the situation with integrity.

Recognize your moral distress.

It’s easy to get swept away with fear. When fear takes over, we can become paralyzed—unable to think clearly or to act in accordance with our values. One way to confront our fear is to recognize and name the source of the angst.

What is causing your distress? Notice tension anywhere in your body. Accept whatever it is you find. What are the conflicting obligations you are confronting? Try to name the conflict.

You may realize that your core value in the current situation is to not cause harm to your patients. You may say to yourself, […]

Amidst Nursing’s Daily Challenges, a Longing for Enduring Meaning

Early ideals, current reality.

I recently co-facilitated a breakout session at a national nursing conference in which we had the participants reflect upon life experiences that sparked their initial desire to go into nursing.

Some knew from a very early age that they were drawn to providing care for others. Others, like myself, were second-career nurses who had spent time in other professions before making our way into nursing.

We spent time talking about our early idealism about the profession and the various experiences or issues that have challenged our ideals over time. I was struck by the deep and broad range of emotions in the room: pride, frustration, hope, discouragement, cynicism, and longing.

‘An almost palpable ache.’

It is the longing that stood out to me the most.

The nurses I met in that room, and nurses I meet everywhere, certainly express longing for better staffing, improved systems that facilitate smoother workflow, and a supportive work environment. But these are all longings that tie into one deeper longing, which is a longing for enduring meaning in our day-to-day work—as hard as some days may be—and a broader […]

Integrating Strong Emotions as a Developing Nurse

Most people, I would venture to say, start off in their profession with a fair degree of idealism, and this certainly holds true for nurses. When I talk with nursing students or new grad nurses and ask their story about why they chose nursing, the most common response runs along the lines of wanting to help others in meaningful ways.

Preparing new nurse grads for nursing realities.

In fact, I will meet with such a group of students this afternoon as I speak on a panel in the ethics class at my nursing alma mater. I, and other colleagues on this panel, want to encourage and inspire. But we will also be telling the students about the challenges we have encountered in situations involving moral distress, ethical dilemmas, and personal burnout. We will present situations when we felt that what we were doing at the bedside was not meaningful because we were only prolonging suffering—or, in other cases, so full of emotion and significance that it felt overwhelming to process.

We want to present the reality of nursing to these students, not to shatter their idealism, but to push them towards meaningful self-awareness from the start of their nursing career so that they are not caught off-guard by the degree to which they will […]

2018-01-18T10:04:09-05:00December 8th, 2017|Nursing|2 Comments
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