Not to Save the World, But to Care, One Life at a Time

A nurse ponders the question of what makes her work matter.

Illustration by Janet Hamlin for AJN.

The Reflections column in AJN‘s August issue, “To Care When There Isn’t Enough,” is by Alison Stoltzfus, an obstetrics nurse at Evangelical Community Hospital in Lewisburg, PA. Stoltzfus describes her experience volunteering as a nurse at a medical clinic in the world’s largest refugee camp, the Rohingya refugee camp in Ukhiya, Bangladesh.

The work could be overwhelming at times. The camp she describes is a place where human illness and suffering often far exceed the capacities of available medical resources. She writes:

Some days the people would throng me in triage, pulling on my clothes and begging to be seen, desperation and longing in their eyes. A longing that at times I had to refuse.

Every day I would ask myself—“How can one care in a setting like this, and make a difference?” What good was it to make a difference to a few when there were so many lives I could not touch and so many problems we could not heal?

One life at a time.

The story centers around the author’s efforts to use the minimal medical equipment available to […]

2022-07-28T09:41:40-04:00July 28th, 2022|Nursing, nursing perspective, nursing stories, pediatrics|0 Comments
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Built for This: One NP’s Revitalized Practice

March 30, 2020, was the first day working at this clinic; it was the same day I was supposed to be returning from my honeymoon in Panama.

That’s from our May Reflections essay, “Built for This,” which is free for the rest of May (along with the entire issue, in honor of Nurses Month). Written by Janey Kottler, a family nurse practitioner and clinical instructor, the essay is about volunteering at a clinic on Chicago’s West Side, which was hard-hit by Covid-19. There she encountered families placed under impossible pressure and risk by the need to keep their jobs during the pandemic.

I think about the single mother and her two children I treated recently. The mother is an essential worker at a grocery store and utilizes her neighbor for childcare during work hours. The family’s neighbors are elderly: the wife stays at home while her husband is an essential worker, working on a factory line. They were grateful to have an income throughout the pandemic until her husband fell ill after COVID exposure at work. He has now inadvertently exposed his wife and the children she babysits.

[…]

2021-05-17T12:42:41-04:00May 17th, 2021|Nursing, nursing career, nursing stories|0 Comments
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‘Right Under Our Noses’: Nightmarish Nursing Home Conditions During the Pandemic

As vaccinations increase and COVID-19 infection rates in nursing homes plummet, it’s easy to forget just how bad things got in many of them and how ill-equipped many were in the the early months of the pandemic to provide humane and effective care.

The following excerpt is from our March Reflections essay, “Right Under Our Noses: Nursing Homes and COVID-19,” which was written by a California nursing professor who volunteered to join a California Medical Assistance Team. The mission of her team was to bring aid to a skilled nursing facility where the coronavirus was rapidly infecting both patients and staff, a facility with little PPE available and many staff members refusing to come to work out of fear of infection.

The conditions I saw were shocking, even to an experienced nurse. I saw soggy diapers on the floor at the heads of many beds on most mornings. One day a bedbound patient needed the bedpan. I searched every closet and drawer but there were no supplies. I filled a basin with warm water and cut up a PPE gown to make washcloths to clean the patient. On the second day of my deployment I realized that many of the […]

2021-03-18T12:10:25-04:00March 18th, 2021|COVID-19, Ethics, infectious diseases, Nursing, nursing perspective, safe staffing|1 Comment
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The First Injection

A nursing professor, now administering Covid-19 vaccinations as a volunteer, looks back on her 40 years of giving injections. The first one was the hardest. 

‘I could have easily given up that day.’

I reviewed the chart the night before—“40 units of NPH insulin subcutaneous before breakfast”—then went home to practice the technique. With a tiny needle and a small volume of medication. I used an orange to simulate the skin and gain confidence in how to puncture the skin and push the plunger to inject the medication.

As I entered the ward with my fellow classmates the next morning, I felt prepared to give my very first injection. I removed the insulin from the refrigerator and began to warm the vial between my fingers. I carefully selected the 100 unit insulin syringe. As I slowly drew up the dose, nervously flicking the air bubble out of the top of the syringe, my clinical instructor watched from the side.

Before we went into the room I checked the record for site rotation—right side of belly. I swallowed hard. We knocked and entered the room, introducing ourselves and our plans for the patient’s morning insulin. The older man lying in bed nodded approvingly. When I pulled up his gown and searched the right side of his belly, I began to have doubts. I hadn’t practiced an injection in the belly and the man’s skin was dry and wrinkled—nothing like the smooth skin of the orange I’d used the night before.

I swabbed the area with the […]

2021-03-12T15:19:08-05:00February 10th, 2021|Nursing|2 Comments
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How to Know When to Go: One Nurse’s Approach to the Retirement Question

Many possible takes on ‘retirement.’

When I meet many of my nursing school mates from (too many) years ago, conversation inevitably turns toward talk of retirement. There are many angles to this, from “Are you going to retire?” to “Are you thinking of slowing down?” to “What are you going to do next?”

I have friends who couldn’t wait to retire and wanted nothing more than an empty schedule to be able to make spur-of-the-moment decisions about what they wanted to do or not do. Others I know also retired fully from nursing but now are docents in museums, driving meals-on-wheels, supervising exercise in an elderly day care facility. And of course there are many who just “cut back”—they work part-time or per diem, but “keep their hand in.”

Photo by Aaron Cynic.

But the decision on when to leave a full-time career can be a difficult one, as the author of the July Transitions column, “What Would Ellen Do?” (free until August 20), points out.

Ellen Elpern was an advanced practice critical care nurse at Rush University Medical Center in Chicago, a large urban academic medical center, loved the work and enjoyed working with her colleagues.

In making her decision to retire, she says, […]

2020-07-31T09:55:24-04:00July 31st, 2020|career, Nursing, nursing career|1 Comment
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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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