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 […]

On-Demand Nursing Jobs: And Other Recommended Reading from AJN’s June Issue

The June issue of AJN is now live.

What factors are predictive of hypoglycemia among inpatients with type 2 diabetes? Read Timple and colleagues’ Original Research article, “Predictors of Hypoglycemia in Patients with Type 2 Diabetes in Acute Care Settings: A Retrospective Correlational Study,” to learn more.

This month’s CE article, “An Adolescent with Undiagnosed Inattentive-Type Attention Deficit–Hyperactivity Disorder and Comorbid Migraine: A Case Report,” describes an adolescent with inattention and migraine who was not diagnosed with ADHD until age 14, when the teen established care with an NP experienced in treating ADHD.

“Professional Licensure: Protecting Your Nursing Livelihood, Part 3,” the final article in a series on protecting one’s nursing license, discusses the public nature of disciplinary action, collateral implications, and suggestions for maintaining one’s license in good standing.

Read about the flexibility, autonomy, and risks of gig nursing in our June AJN Reports, “On-Demand Nursing Jobs.”

In “The Impact of a Low-Technology Medication Organization System on Hospital-at-Home Medication Errors,” the authors describe an interdisciplinary quality improvement project to mitigate errors resulting from misplaced or misused medications among hospital-at-home patients.

“Librarian Partnerships in DNP Education,” the sixth article in a series on how to teach and facilitate learning […]

2025-05-22T10:58:39-04:00May 27th, 2025|Nursing|0 Comments

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 […]

Ultrasound-Guided IV Cannulation: And Other Recommended Reading from AJN’s February Issue

In recognition of American Heart Month, our February cover features Takotsubo Cardiomyopathy (Broken Heart Syndrome), a painting by Amy Doerwang. See On the Cover to learn more.

The February issue of AJN is now live.

This month’s CE article, “Using Ultrasound-Guided Cannulation for Difficult IV Access in Medical–Surgical Patients: A Quality Improvement Project,” examines the impact of ultrasound-guided peripheral intravenous (PIV) cannulation on the rate of first-attempt PIV access among patients with difficult IV access.

“Professional nursing organizations can play a significant role in educating and preparing nurses to work more effectively toward achieving the UN Sustainable Development Goals,” write Janice Hawkins and colleagues in their Original Research article, “Nurses’ Perceptions of the Role of Nursing Organizations in Promoting Engagement with the Sustainable Development Goals: A Global Study.” Learn about their study findings here.

“Professional Licensure: Protecting Your Nursing Livelihood, Part 2,” the newest installment in a series on protecting one’s nursing license, outlines common causes of licensure discipline, the disciplinary process, and potential penalties.

“A Military–Civilian Training […]

2025-01-23T06:41:11-05:00January 23rd, 2025|Nursing|0 Comments

When Nurses Are Caught Between Hospital Policy and Frustrated Family Members

A difficult exchange

Photo by Riccardo Chiarini on Unsplash

She was one of those patients who remind me of my own daughters, who make me consider up close what it would feel like to watch a terrible disease process insidiously take over my own child’s body. Her cancer had spread and she was struggling to breathe.

The team had told the parents it was likely we might have to give her a breathing tube before my shift was over. The parents were teary-eyed as I told them I would do my best to walk with them through a difficult day. They went downstairs to get food, at which point the patient, who had been dozing in bed, sat up and looked around. I went to her immediately, rubbed her back, and assured her that her parents would return shortly.

When her parents returned to the room, they brought more visitors than the three that our hospital policy allowed. I was a little anxious because I had already heard that this had been an issue overnight and that the parents had pushed back on efforts by another nurse to hold them to the policy.

I did my best to wait for a moment when bringing up the hospital policy […]

2024-11-04T09:49:56-05:00November 4th, 2024|Nursing|1 Comment
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