Nurses Know Safety Can’t Depend on Assumptions

In health care, we are trained not to rely on assumptions. We build systems that anticipate risk, standardize response, and make the next step clear before it is needed. When something goes wrong, we do not improvise. We follow a plan that already exists.

This is why it is so striking to encounter environments where safety depends almost entirely on assumption.

The tragic example of AED accessibility.

I began thinking about this outside of health care. I came to this through someone I know, John Ellsessar, whose life has been shaped by loss. His son, Michael, died at 16 after suffering sudden cardiac arrest on a high school football field where an AED was not immediately accessible.

That experience changed what he did next. It also changed how I think about a question that often goes unasked: What is the plan when something goes wrong?

Consider sudden cardiac arrest. It is one of the few situations in medicine where the response is both straightforward and time-dependent.

When John explained it to me, he put it simply: A heart attack is a plumbing problem, a blocked artery.
Sudden cardiac arrest is an electrical problem. The heart’s rhythm […]

2026-05-15T13:18:43-04:00April 27th, 2026|Nursing, Public health|0 Comments

What’s in the Air? Rethinking Airflow and Infection Risk in Health Care

Image generated using Google’s Nano Banana 2, 4/20/26.

For nurses, environmental infection prevention is often framed around visible conditions such as high-touch surfaces, shared equipment, and visible dirt. In my experience, airflow and ventilation are not topics that receive significant emphasis in nursing education or orientation. While this may vary by setting, many nurses are left to learn these concepts in practice rather than through formal training.

With the recent COVID-19 and measles outbreaks, there has been more focused attention placed on contaminated air as a risk to patient safety. In my work with health care teams across settings, I’ve found that while nurses are highly attuned to cleaning and disinfection practices, airflow and ventilation are often assumed to be “handled” by the facility operations staff. In reality, these systems depend heavily on how the environment is used at the bedside. Small, routine actions—like leaving a door open or introducing a fan—can unintentionally disrupt carefully designed controls.

This gap in awareness among clinical staff matters. While the Centers for Disease Control and Prevention continues to report progress in reducing health care-associated infections (HAIs), these infections remain at a persistent risk for patients. Expanding the nurse’s focus on the environment […]

From Care to Calling: How a Nurse’s Small Act Became a Lifelong Inspiration

Often, the simplest questions lead to the greatest moments of reflection and growth. While serving on a recent panel discussion, I was asked how I knew I wanted to be a nurse? The question offered me the opportunity to reflect on the butterfly effect of one nurse’s actions on the future of a teenage girl.

A mother’s sudden illness

I was 17 years old, a junior in high school, and growing increasingly excited about my first prom. The dress was picked out, the makeup decided, and my high school sweetheart (and current husband) had already asked me to be his date. Just prior to the big day, my mother began experiencing worsening headaches and increasingly noticeable vision changes. Though it was originally written off as stress or typical age-related vision changes, an eye appointment for a new prescription quickly led to a neurology consultation. With roughly 50% of my mother’s peripheral vision already gone, scans were ordered, and a craniopharyngioma was discovered.

Suddenly, prom was the last thing on my mind as my mother was admitted to a local cancer hospital for treatment of a large (noncancerous) brain tumor. Her surgery was scheduled for the day of the big dance. Her last words before being wheeled into surgery were, “When I wake up, the first thing I want to see are pictures of how beautiful you looked at the prom.”

How to Keep Caring Without Breaking

Recently, a nurse asked publicly how others cope with empathy fatigue.

It struck me that the question itself was brave.

Empathy fatigue (more often called compassion fatigue) is easy to mislabel. It can present as irritability, detachment, or impatience. It can look like burnout. It can feel like failure. But often, it is something quieter and more specific: the accumulation of caring deeply for a long time.

The subtle internal shift signaling empathy fatigue.

The most dangerous part of empathy fatigue isn’t exhaustion. It’s the subtle shift.

It’s the moment you feel yourself pulling back. The internal eye roll that surprises you. The thought you don’t like having. The faint edge of resentment where compassion once felt natural.

That shift is uncomfortable. But it is also a signal.

In oncology, relationships are not brief. We see patients repeatedly. We learn their children’s names. We know when scans are coming. We recognize the weight in their voices before they say anything at all. Over time, that proximity to suffering accumulates. Grief does not arrive all at once. It layers.

Empathy fatigue is not evidence that we care less. It is often evidence that we have cared continuously.

Left unnamed, however, it can harden into something else. Resentment is not dramatic; it is […]

Nurses as Vital Partners in the Fight Against Antimicrobial Resistance

Photo: Shutterstock

Reducing the impact of antimicrobial therapy is a part of fundamental practice for health care providers, pharmacists, microbiologists, and public health professionals. Inclusion of nurses in the conversation regarding actions and implementation to achieve this end has often been an afterthought.

However, the number of nurses practicing across every health care setting makes us critical and active partners. What, specifically, are the roles and actions of nurses in addressing antimicrobial resistance, antimicrobial stewardship (AMS), and safe patient care and outcomes? Let’s first review the basics of the problem.

Nursing Activities Relevant to Antimicrobial Use and Stewardship

The approximately 5.77 million active nurses in the United States are widely trusted and well positioned to provide education on antibiotic use and influence behavior related to antimicrobial therapy. Their universal presence in health care settings empowers them to play a role as frontline actors in antimicrobial stewardship across inpatient, outpatient, and community settings. To make this happen, programs supporting appropriate use require commitment from health care leadership, available expertise in antimicrobial drug use, regular performance evaluation, […]

2025-07-14T10:38:24-04:00July 14th, 2025|Nursing, patient safety|0 Comments
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