Helping Patients Live Inside Changing Realities

Why earlier palliative care conversations matter in oncology nursing

Image of oncology nurse and a patient discussing palliative care options in a warm and supportive settingOne patient I still think about came in frequently for supportive care visits. Technically, the appointments were straightforward. She was there for things like IV fluids or symptom management. But her visits were rarely simple. She had questions about labs, treatment side effects, fatigue, and what different changes in her body meant. Over time, our conversations expanded beyond the immediate medical task in front of us.

She talked about how much harder everyday life had become. She tired easily. Walking longer distances became difficult. She was losing independence in ways that frightened her. Eventually, we began talking about mobility aids. She did not want a walker or wheelchair. To her, they represented loss.

I remember trying to reframe the conversation. I told her that using a walker did not mean she had stopped living fully. If being outdoors mattered to her, then the goal was not preserving the image of how she used to move through the world. The goal was helping her continue participating in the parts of life she still loved. A wheelchair might allow her […]

Disaster Care, Brain Drain, More: Recommended Reading in AJN’s March Issue

The March issue of AJN is now live.

“Nurses play a critical role in disaster preparedness, response, and recovery,” says Linda M. MacIntyre, PhD, RN, PHN, FAAN, chief nurse of the American Red Cross (see On the Cover). Two articles in this month’s issue address disaster care:

Brain drain is increasing in health care. “Original Research: Nurses’ Attitudes Toward Brain Drain and the Associated Factors” explores the attitudes of Turkish nurses, nurse academics, and nursing students toward this problem in the nursing profession.

In this month’s CE article, “Beyond PICO—A New Question Simplifies the Search for Evidence,” the authors present the framework for an alternative to the PICO question—PPCO, or problem, population, change, outcome—that provides a universal approach to question development for evidence-based practice QI initiatives and for all nursing issues that need addressing.

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2024-02-26T09:29:37-05:00February 26th, 2024|Nursing|0 Comments

AI and Nursing: Recommended Reading in AJN’s October Issue

The October issue of AJN is now live.

This month’s AJN Reports takes a close look at how artificial intelligence is being used in health care—and why nurses must be involved in its development and implementation.

“Current and Emerging Applications of Fecal Microbiota Transplantation” describes the use of this procedure to treat recurrent Clostridioides difficile infection, nursing management of individuals undergoing it, and its future applications. CE credit is available.

To learn more about the potential oral complications of adjuvant endocrine therapy in breast cancer survivors, the authors of the October Original Research article compared aspects of oral health in those who were taking the therapy with those who were not.

“Activism Is an Essential Nursing Role” discusses the rationale for and roots of political activism in nursing, the values that shape it, and the importance of nursing’s stance on health-related policies.

How can nurses best attend to seriously ill patients’ existential needs? Read “Perspectives on Palliative Nursing: Existential Care in Daily Nursing Practice” for an overview of key priorities.

See also the extensive health care news sections, the Journal Watch and Drug Watch sections, a Specialty Spotlight column highlighting critical care […]

Preventable and Aggressive Care for Cancer Patients: To the Bitter End

There have been a couple of recent studies that confirm what I have observed as a palliative care nurse practitioner (NP) in an academic medical center: that there’s still a tendency to pursue very aggressive care with older people with cancer. While every situation is different, the evidence shows that people with cancer could also benefit from palliative care and advance care planning to make sure they’re getting the best and right care for them.

Palliative care could prevent many ED visits.

The first study to catch my eye as a former ED nurse was Trends and Characteristics of Potentially Preventable Emergency Department (ED) Visits Among Patients With Cancer in the US. This study reviewed data on almost a billion (854,911,106) ED visits, of which 4.2% were made by patients with cancer. The mean age of those patients, not surprisingly, was 66. The study found that more than half of ED visits among patients with cancer, 51.6%, were identified as potentially preventable, with the absolute number of potentially preventable ED visits increasing substantially between 2012 and 2019.

The authors concluded that this highlights “the need for cancer care programs to implement evidence-based interventions to better manage cancer treatment complications, such as uncontrolled pain, in outpatient and ambulatory settings.”

This sounds […]

November Issue: Nurse Vaccine Hesitancy, the Staffing Crisis, Palliative Care, More

“As nurses, we must push back on public health misinformation where and when we can, so that we don’t return to the days when viruses such as polio thrived and spread, and human health needlessly suffered.”—AJN editor-in-chief Carl Kirton in this month’s editorial

The November issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

Original Research: COVID-19 Vaccine Hesitancy Among Southern California Nurses

This study aimed to elucidate the characteristics of vaccine-hesitant nurses at two large medical centers where rates of COVID-19 vaccination were lower than expected, and to understand the reasons for such hesitancy.

Viewpoint: Reframing Hospital Nursing as a Specialty to Address the Staffing Crisis

In light of the current shortage of hospital nurses, the authors propose recasting the role as a specialty—instead of as an entry-level position—and call for an overhaul of nursing education, particularly clinical experiences.

CE: What COVID-19 Can Teach Nurses About Liability Risks

This article explores key nursing liability issues associated with the pandemic, including immunity, documentation, crisis standards of care, delegation and assignment, scope of practice, floating, travel nursing, telehealth, and misinformation and social media.

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2022-10-21T08:14:54-04:00October 21st, 2022|Nursing|0 Comments
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