Posts Tagged ‘patient-centered care’

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Magnet Hospitals: It’s About the Process, Not the Designation

January 23, 2012

By Shawn Kennedy, AJN editor-in-chief

When I had a recent medical emergency, I went to the local community hospital near my home in northern New Jersey. I had been there before for outpatient testing or to the ER with a child and found the care attentive and efficient and the staff friendly and professional. Besides, it was a Magnet-designated hospital, so I was confident that I’d receive good care.

The ancillary staff was wonderful, but I found myself disappointed with the nurses on the acute med/surg unit where I was located. There was no rounding that I was aware of, and they seemed to only show up when it was time to administer meds. Only a few nurses introduced themselves, and only two nurses over three days really engaged me in any conversation. Nurses seemed to respond to call lights only for those patients to whom they were assigned. The unit clerk who promptly answered the call light intercom would say, “I’ll let your nurse know and she’ll be in soon”—when I asked for pain medication, she told me “your nurse is giving report; I’ll let her know when she’s finished.” I waited uncomfortably for more than half an hour.

There were whiteboards, but often the information—especially regarding the date and the name of the nurse—was unchanged from day to day and no longer accurate. (This was annoying, in that they kept asking me what date it was and I kept getting it wrong!)

The worst, though, was the noise level at night. I’ve worked nights, and I know it’s easy to forget to keep conversations hushed. But this unit was a good example of those that are as “noisy as chainsaws” (see our recent post on this). I was two doors down from the nurses’ station and I could hear every conversation, people singing holiday carols, detailed discussions of patients (forget HIPAA!). Requests that they reduce the noise made no difference. One night, I learned every detail about one nurse’s vacation plans while she and a colleague spoke in normal, conversational tones, occasionally laughing, while providing care to the elderly woman in the bed next to me at 2:30 am.

When I asked if they could speak a bit more quietly, one of the nurses angrily pulled back the curtain and told me that I had to understand that they needed to take care of the woman and would be done shortly. She then resumed talking about her vacation. I barely slept at all the three days I was there. It was exhausting, and I was happy to get home.

A few days later, I was admitted to a large teaching medical center in Manhattan, where I stayed for 10 days. The contrast was startling. The ICU nurses were incredibly attentive and supportive; they made me and my family feel that I was safe and in excellent hands. On the med/surg unit, the nurse manager introduced herself when I arrived. My assigned nurse for each shift would introduce herself and ask me if I needed anything; she came by frequently, even if only to poke her head in the room and say, “Everything OK?” Nursing assistants likewise introduced themselves and would inquire if I needed anything. Read the rest of this entry ?

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The Monkey in Room 100

June 2, 2011

By Karen Gonzol, MSN, RN. Karen is an assistant professor in the division of nursing at Shenandoah University in Virginia. This is her first post for AJN.

I saw him again, just a few days ago. It has been nearly two years since Mother died, but there he was, peering at me from his perch in my sister’s laundry room.

Mother had been placed on hospice care for her congestive heart failure. She settled somewhat reluctantly into the nursing home and waited for the end.

As she discovered that the wait was going to be much longer than she’d planned, she decided to go on with living. Her room was on the first floor, with a window facing out into the courtyard. The staff loved her, and she loved to tease them. She made an effort to learn their names, and when she couldn’t remember she made up nicknames, such as “Bow Lady” for the assistant who always wore a huge bow to tie back her hair. One July day she began asking, “Do you see those monkeys in the tree out there?” Read the rest of this entry ?

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Promoting Awareness of Patient-Centered Care

October 7, 2010

By Shawn Kennedy, AJN interim editor-in-chief

October is, among other things, patient-centered care awareness month. At AJN, we’ve been focusing on patient-centered care for some time, most recently by virtue of our collaboration on a series of articles with Planetree, a nonprofit that “facilitates patient-centered care in healing environments.” The first article, Creating a Patient-Centered System, appeared in March 2009; the final article (from which we took the image above) was published in September 2010, and they’re all available in a collection on our Web site. Articles focus on such topics as creating quieter hospital environments and promoting patient access to medical records. We’re excited that this collaboration evolved into a four-part free webinar series supported by the Picker Institute. The final webinar, A Patient-Centered Approach to Visitation, presented by Planetree vice president Jeanette Michalak, MSN, RN, along with Wendy Tennis, BA, and Nancy Jane Schreiner, BSN, RN, will be on October 19 at 1 pm EST. We hope you will register and learn how to facilitate family visitation that meets patient needs. (The Planetree Web site also offers a downloadable toolkit and suggestions to focus attention on patient-centered care.)

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