December Issue: Nurses’ Advance Care Planning–Related Beliefs, Managing Movement Disorders, Delegating, More

“When despair for the world grows in me…. I come into the peace of wild things who do not tax their lives with forethought of grief. I come into the presence of still water…. I rest in the grace of the world, and am free.”—Wendell Berry, as quoted in the December editorial

The December issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Advance Care Planning: An Exploration of the Beliefs, Self-Efficacy, Education, and Practices of RNs and LPNs

The authors of this study surveyed RNs and LPNs working in skilled nursing facilities to learn about the similarities and differences in their advance care planning–related beliefs, sense of self-efficacy, education, and practices.

CE: Managing Movement Disorders: A Clinical Review

This article discusses the pathophysiology and assessment of three different, common neuromuscular disorders—muscle tightness, spasticity, and clonus—as well as the treatment options for each.

Cultivating Quality: Creating a Culture of Mobility: Using Real-Time Assessment to Drive Outcomes

The authors describe how they implemented an intervention based on the use of three new assessment tools to promote awareness of the importance of early mobility among nurses and […]

2018-11-26T08:38:54-05:00November 26th, 2018|Nursing|0 Comments

Enough with the Scare Tactics: Some Follow-Up on the IOM Report on the Future of Nursing

Shawn Kennedy, AJN’s interim editor-in-chief, already posted here about the importance of the recently released Institute of Medicine Report on the Future of Nursing. Its implications are particularly profound at a time when we have a scarcity of primary care providers—and also at a time when the Affordable Care Act (i.e., health care reform) has designated more resources to nursing education and to generally making better use of nurses’ expertise. A number of bloggers have written about the IOM report, several of them expressing chagrin about the predictably naysaying American Medical Association response. Rebutting the AMA, the Center for Health Media and Policy at Hunter College had this to say. One working NP who weighed in on this topic is Stephen Ferrara, who noted (almost two weeks ago, in fact, though we missed it until now) the real world implications of the current situation for NPs in New York State, in a succinct post on his blog, A Nurse Practitioner’s View:

The bottom line is (at least in NY where I practice), without a collaborating physician on record, the 14,000 or so NPs are unemployed and can’t legally do anything that we were trained or educated to do. It is time to remove these non-evidence based barriers and retrospective reviews and allow us to function as true partners on the health care team. Collaboration among providers would still continue to happen and I promise pigs wouldn’t start to fly. Fourteen states have already transitioned to to an […]

Advanced Practice Nurses: Pushed Forward by Health Reform Advocates, Pushed Back by Physicians over Turf – Enough Already!

By Shawn Kennedy, MA, RN, AJN editor-in-chief

As we’ve noted in past posts on this blog and in AJN editorials in August 2006 and August 2008, organized medicine does not want to acknowledge that nurses can practice independently.  And now the turf war between advanced practice nurses (APRNs, which include nurse practitioners, nurse anesthetists, nurse midwives and clinical nurse specialists) and physicians is heating up.

In California, physicians are suing the state for allowing nurse anesthetists to practice without supervision, using patient safety as a reason. In Kentucky, physicians are opposing legislation to expand the scope of practice for NPs—at issue is whether NPs should need a signed collaborative arrangement with a physician (even though the physician does not supervise the NP). According to an article by a Louisville, Kentucky, newspaper, the Courier-Journal, the physicians charge high fees for their signature or demand a percentage of the practice.  The bill, though, passed the state House committee on March 4, with several members questioning the ethics of physicians’ requiring fees.

Nurses have been and continue to fight for the right to practice, and during this period where the government is seeking solutions to health reform, this is a battle that shouldn’t have to happen—a view shared by Stephen Ferrara, NP, at A Nurse Practitioner’s Place (“I have tried to refrain from taking the bait from some recent negative opinions regarding nurse practitioner delivered care”). […]

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