Beyond ‘This Is How We Do It’: Teaching Nurses to Think Critically About Practice

A nurse I was orienting asked a question that stopped me.

“Why do we have to wait for a current type and screen before ordering red blood cells, but not platelets?”

It was the kind of question that should have a clear answer. She wasn’t new to nursing, just new to our unit, which made it land differently. This wasn’t inexperience. It was a fresh perspective on a practice I had stopped questioning.

I had a general understanding. I knew that red blood cells carry the antigens most likely to trigger clinically significant antibody formation, and that ensuring compatibility before transfusion is critical. Platelets, by comparison, are less likely to require the same level of matching in routine situations. But when I tried to explain it clearly and completely, I hesitated.

My first instinct was to simplify the answer: “That’s just how we do it.” I paused before saying it out loud. Although the practice made sense to me, I had never examined it in a way that I could confidently teach, explain, or connect back to policy.

The question exposed a gap between practice, policy, and understanding. It also raised something larger: how often do we follow practices we can’t fully explain, document, or defend?

This experience highlighted a broader […]

2026-04-15T09:24:30-04:00April 13th, 2026|Nursing, questions of practice|0 Comments
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The Ethical Use of our Therapeutic Connections with Patients’ Families

“What would you do, doctor?” The family had been explicit in wanting straightforward communication about their child, whose neurological disease had progressed to the point where she was continually seizing, despite every medication the physicians had tried. The seizures were in turn damaging her brain, such that she was minimally responsive to stimuli and was not expected to regain significant awareness of her surroundings.

I held my breath as I anticipated the doctor’s reply. She had spent many hours with this patient and family, and had built trust with the parents.

“As a physician . . . I would transition my child to comfort care and ultimately let her go. But as a mother . . . I would struggle to do this.”

The patient’s mom nodded tearfully. The doctor had given an honest reply, and had still ultimately left the choice to the parents.

I took care of this patient in her final few days of life. The parents were heartbroken but also clear in their decision. We walked them through each step, and made sure they felt supported to the best of our ability, down to their very last goodbye with their child.

******

There is power in the medication and therapies we apply. Fluid and […]

2025-12-18T10:39:59-05:00December 18th, 2025|Ethics, family, family experience, narratives, nursing roles, nursing stories|1 Comment
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Deep Research: Understanding the Limitations of the Latest Powerful AI Tool for Scholarly Authors

In February 2024, I wrote an AJN Off the Charts blog post titled “Leveraging AI and Technology for Comprehensive Research: Tips for Researchers and Students.” Since then, the field of AI has undergone rapid evolution. It is evident to all of us watching the field develop that companies hosting and developing large language models (LLMs) would eventually target scientific research. In my previous post, I explained that there is no single software solution for conducting research or literature reviews using AI. However, the deployment of new features in AI software platforms, such as deep research capabilities, may mislead us into thinking otherwise. The purpose of this blog post is to introduce the idea of deep research tools, while also providing tips for users who wish to explore these evolving tools.

What is deep research?

Image: Marcus Winkler/Unsplash

Deep research is a term used by LLM software platforms that allow users to enter a prompt to initiate an in-depth process that involves finding, analyzing, and synthesizing “hundreds of online sources to create a comprehensive report at the level of a research analysis” (OpenAI, 2025). There is also a consideration for time using this tool, as the responses are not instantaneous and result time can vary based on […]

2025-11-18T09:05:01-05:00November 18th, 2025|artificial intelligence (AI), Nursing, nursing research, Technology|0 Comments
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In Times of Overwhelm as a Nurse and Citizen, Begin with One Intentional Act at a Time

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN

With the recent devastation and loss around our local Los Angeles wildfires as well as our country’s political disarray, one of the most difficult things about trying to remain empathetic, engaged, and informed as an individual and a nurse has been a sense of utter overwhelmedness.

I think most nurses are both empathetic and action-oriented, traits which can be helpful—but also sometimes crippling when we see needs for help and advocacy everywhere and don’t know where to start. Any action feels like such a miniscule drop in the bucket.

I was carrying this emotional, mental, and spiritual heaviness into work with me a couple of days ago. I sat down to get report on my patient assignment. My patient was so sick, so complicated; she’d been teetering between life and death in recent days. Her parents had been on a roller coaster of the worst kind. ‘Two weeks into this hospitalization, are we still holding onto hope for recovery? Are we gathering relatives to say goodbye?’

I knew I was walking into a space that was very loaded for the parents. They had seen many nurses, respiratory therapists, and doctors come through their doors. For as long as they had been in our unit, this […]

2025-03-03T14:13:18-05:00March 3rd, 2025|family experience, Nursing, nursing perspective, nursing stories, pediatrics|0 Comments
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H5N1 Avian Influenza (Bird Flu) Update for Nurses and Other Health Providers

Influenza is a clever virus and one that deserves respect. Current concerns with the H5N1 avian influenza virus strain demonstrate why public health around the world continues to watch and monitor for impact on human health. Although the situation is not one that currently affects us on a day-to-day basis, it is important that we have a basic understanding of why this remains newsworthy.

Spread and evolution of H5N1.

Since its emergence, H5N1 has spread across multiple continents, affecting wild birds, poultry, and mammals. In late 2023, the virus was detected in Antarctica for the first time, raising concerns about its impact on native wildlife. By 2024, H5N1 had been reported in various regions, including Europe, Asia, and the Americas, leading to significant poultry losses and economic challenges.

In the United States, H5N1 has been detected in wild birds, poultry, and mammals across all 50 states. As of early 2025, nearly 70 human cases have been confirmed, primarily among individuals with direct exposure to infected animals. In December 2024, the Centers for Disease Control and Prevention (CDC) confirmed the first severe human case of H5N1 in Louisiana, involving a patient hospitalized with severe illness.

We have seen H5N1 move across nonhuman animal species, to situations where humans have become mildly ill after contact with animals, and now to situations where animal contact has resulted in severe human illness.

Since this particular strain of influenza has been detected in a variety of animals, but rarely in humans, what is the concern? The concern […]

2025-02-13T12:42:43-05:00February 13th, 2025|infection control, infectious diseases, Nursing, Public health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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