Those Special Moments Nurses Sometimes Talk About

Before I became a nurse, I heard that nurses have special moments with their patients and families that they never forget, but I never truly understood what that meant.

My first neonatal code occurred about six months after I completed my orientation in the pediatric emergency department. I remember that shift being a particularly busy one. In the midst of the hustling and bustling of assessing and medicating patients and reevaluating and discharging them, I heard banging on the triage door and saw a mother and father wheeling in their baby carriage, frantically crying out that their baby Skye was blue in color.

By S.Hermann and F.Richter/Pixabay

I remember quickly removing her clothing and seeing how cyanotic she was, all while an electrocardiogram was being obtained and she was placed on the cardiac monitor. I recall hearing the doctors paging overhead for pediatric respiratory and anesthesiology to assist with resuscitation. Other team members included a CNA and a medical student who tried to relax the parents but were understandably not successful.

There were multiple unsuccessful attempts to obtain peripheral vascular access in Skye. I can still see the look of terror on Skye’s parents’ faces as the drill gun used to insert the intraosseous access whirled into baby Skye’s bone, […]

2020-10-23T10:48:41-04:00October 23rd, 2020|family experience, Nursing, Patients, pediatrics|0 Comments

How Can We Improve the Hospital Experience of Visually Impaired Patients?

VIP Care Toolbox used in QI project

“Hello, I’m your nurse, Jane. Are you able to see me clearly?”

I have trouble functioning without a pair of eyeglasses within reach. If I were in the hospital without my glasses, I’d be at a loss—unable to read for pleasure, let alone read menus or instructions or consent forms. How much harder is it for people with moderate vision loss, or those who are totally blind?

Christine Carlson and her colleagues at St. David’s North Austin Medical Center in Austin, Texas, set out to answer this question. They met with visually impaired people in the community, reviewed the literature, and surveyed their own staff in order to learn the best ways to accommodate the unique needs of visually impaired patients, or ‘VIPs.’

In “Caring for Visually Impaired Patients in the Hospital: A Multidisciplinary Quality Improvement Project” in the May issue of AJN, the authors highlight how frightening and frustrating a hospitalization can be for those with limited or no sight, and share simple, practical interventions that can make an enormous difference in the safety and quality of a VIP’s hospital experience.

“I’m always afraid to go to the hospital. They don’t know […]

2020-05-21T09:52:23-04:00May 21st, 2020|patient experience, Patients|0 Comments

Addressing Harassment and Intimidation by Patients and Family Members

Since arriving at the skilled nursing facility after surgery for throat cancer, Ray had been attempting to touch female nurses inappropriately and had recently started making kissing motions at one of them whenever she entered and left the room.

Tacit acceptance of the unacceptable.

Though his behavior was recognized as unacceptable, most nurses had simply been redirecting him or telling him to stop, with no further consequences. Some explained the harassment away as the crude behavior of an old man who didn’t know any better. He’s from a different time; things were different back then. Some dismissed it as harmless. He thinks he’s being flirty. For others, his behavior was a mild though not particularly threatening irritation. He can’t even get out of his wheelchair—what’s there to worry about?

A symptom of cognitive decline, or plain old bullying?

The situation was complicated by the fact that Ray could not communicate verbally as a result of surgery, had short-term memory impairment, and difficulty concentrating. Although he appeared cognitively sound, there were just enough complications in communication and attention to cause some to speculate that he might be having neurocognitive decline that had disinhibited his self-restraint.

For others, Ray was a bully, maybe even a predator. He was taking advantage of access to female staff who were required to […]

2019-11-14T10:28:12-05:00November 13th, 2019|career, Nursing, nursing career|0 Comments

In Health Care, We All Have Biases

Everyone involved in health care is likely aware of the disparities that exist in the system, from private patients who get fast-tracked and admitted to private rooms (all hospitals seem to have a “VIP” floor) to individuals who must wait until they are very ill and then can be treated as an emergency. And even though our ethics dictate otherwise, we know that, often unconsciously, we treat some patients differently.

Awakening to our preconceived notions and preferences.

Addressing Implicit Bias in Nursing: A Review,” written by Mary Curry Narayan and published in our July issue, discusses how preconceived notions and instinctive preferences can interfere with relationships and change how we treat patients.

Are you as comfortable walking into a room full of people similar to yourself as you are into a room full of people who speak a different language or are from a different background? Do you feel and act the same way towards a private patient with an MI who has a stable job and family as you would towards an unemployed person who has a substance abuse disorder? Will you spend the same amount of time speaking with them?

Recall conversations with colleagues at change-of-shift reports—in my experience, discussions there often color how we feel about patients before we even meet them.

Biases: we all have them.

Narayan points out that the first step in managing our biases is to acknowledge that we all have them—they’re part of our past experiences and are […]

A Moment of Mindfulness: A Nurse’s Mosaic to Remember Patients

A Moment of Mindfulness © 2018 by Tilda Shalof

Noted author Tilda Shalof spent 28 years as an ICU nurse at Toronto General Hospital in Toronto. Over the years, she collected the discarded plastic medical packaging—including medicine caps, tube connectors, and vial lids, all of it sterile. At the suggestion of friend and artist Vanessa Herman-Landau, they used the plastic pieces to create this 4 ft. by 9 ft. mural, which is featured on AJN‘s May issue Art of Nursing page (click through to the PDF version for the best image).

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