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 […]

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

Words Matter – Including Those Left Unsaid

Sticks and stones may break my bones, but words can never hurt me.

How often did we as children say these words to those who teased us? Yet we still felt the sting that unkind and malicious words imparted, especially when said by those we trusted. And it didn’t matter if the taunts were untrue—they still hurt.

Words matter—take youth bullying, for example.

Photo by Benjamin Voros/Unsplash

According to the Centers for Disease Control and Prevention, both bullies and targets of bullying are at high risk for depression, anxiety, and suicidal thoughts. And bullying in nursing is a well-known occurrence and a significant factor in why nurses leave their jobs.

Words matter and are especially important when laws and policies are created.

The words codified in legislation—and those words excluded—dictate funding, programs, and who can participate in the programs or provide them.

Words matter and are especially powerful when spoken by public officials who can influence scores of followers to think and act in certain ways.

I often wonder how many fewer people might have died if more of our leaders had embraced rather than denigrated science-based public health practices during the COVID-19 pandemic.

Words matter when they are used to spread false information or denigrate […]

2024-10-31T12:54:24-04:00October 31st, 2024|Ethics, Nursing|1 Comment
Read More

Nursing Roles in ECMO: And Other Recommended Reading from AJN’s November Issue

This month’s cover photo shows a pediatric patient, Levi Drager, on ECMO at the University of Iowa Stead Family Children’s Hospital. The photo was taken shortly after he became the hospital’s first pediatric patient to take steps while on ECMO. See our “On the Cover” column for more.

The November issue of AJN is now live.

This month’s CE, “Nursing Roles in Extracorporeal Membrane Oxygenation,” discusses the multiple roles of ECMO nurses, the various ECMO delivery care models, and the potential cost savings of an RN ECMO specialist staffing model—and introduces the novel role of the ECMO lead. (Open Access)

“Given that healthy work environments both foster high-quality patient care and allow nurses to thrive, increased efforts to understand the work experiences of ethnic minority nurses are vital,” write Nia M. Martin and colleagues in their Original Research article, “Exploring Black Nurses’ Perceptions of Workplace Safety and Personal Health.” Learn about their study findings here. (Open Access)

“Implementing a Hospital-Acquired Pressure Injury Prevention Bundle in Critical Care,” the third article in our Applying Implementation Science (IS) series, describes how a nurse-led IS team at a multisite health system used IS concepts, methods, and tools to implement a […]

2024-10-24T12:42:34-04:00October 24th, 2024|Nursing|0 Comments
Read More

Coping with Alarm Fatigue: And Other Recommended Reading from AJN’s October Issue

The 1956 painting by Gerald McLaughlin on this month’s cover is titled “Act as if the whole election depended on your single vote, and as if the whole Parliament (and therein the whole nation) on that single person whom you now choose to be a member of it.” See our “On the Cover” column to learn about this work and why we chose to feature it.

The October issue of AJN is now live.

“The frequent and often simultaneous ringing of alarms, including many that are false, nonemergent, or nonactionable, has led to overwhelm, alarm distrust, and desensitization,” write Olawunmi Obisesan and colleagues in this month’s Original Research article, “Alarm Fatigue: Exploring the Adaptive and Maladaptive Coping Strategies of Nurses.” Their study findings indicate a need for interventions and redesigned protocols.

The October CE article, “Functional Medicine in Nursing,” explains the core principles of functional medicine—a patient-centered approach that seeks to address the underlying causes of disease rather than focusing on managing the symptoms—and how nurses can learn and incorporate it into their practice.

Election Day is approaching. Two articles in this issue address why voting is crucial—and how barriers to doing so threaten democracy and can impact health policy:

2024-09-26T10:15:59-04:00September 26th, 2024|Nursing|0 Comments
Read More

Blood Culture Bottle Shortage: Reducing ED Utilization in One Health System

Jonathan Nover, MBA, RN
Vice President of Nursing | Emergency Services
Mount Sinai Health System, New York City

The problem.

In early July 2024, a nationwide blood culture bottle shortage was announced. At the Mount Sinai Health System, specifically for our eight emergency departments (ED), naturally high utilizers, it was critical to devise contingency plans to reduce utilization and preserve supplies. Since it was evident early on that ED nursing would play a critical role in reducing utilization and waste, it was crucial to understand our current burn rates, utilization rates, contamination rates, and fill volume rates. We would need to recalibrate our blood culture stewardship and check in with our teams to understand workflows and their knowledge baseline about the nationwide shortage.

Discovering a gap in knowledge.

Through varying methods including huddles; “walking the GEMBA” with nursing leaders, epidemiologists, and infection preventionists; and eliciting transparent feedback we learned very quickly that our ED teams were not all aware of the top reasons for blood culture waste.

A nursing practice alert.

We created a nursing practice alert to highlight several key elements we’d learned . The areas of focus,

2024-09-12T10:31:16-04:00September 3rd, 2024|Nursing|0 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top