The Personalities of Veins: What Thousands of IV Starts Have Taught Me

The grape.

“I have rolling veins.”

I’ve heard some version of this warning hundreds of times before placing an IV. When a patient tells me their veins roll, I picture a grape sitting on an empty plate.

Imagine trying to pick up that grape with a fork. If you approach it gingerly, trying to delicately pierce the skin, the grape is likely to slide to one side. Instead, you have to commit. You need a quick, deliberate motion—enough force to pierce the grape, but controlled enough that the fork doesn’t go straight through it.

Some veins are like that.

When I find a firm vein that wants to move away from me, I anchor the vein as well as I can, knowing that doing so may flatten the very spot that initially looked so promising. Then I approach it with measured force—a controlled jab. Enough commitment to enter the vein before it can escape, without so much force that I go through the other side.

Sometimes I explain the grape analogy to patients after they’ve warned me about their rolling veins. It often makes them smile, but it also gives them a way to understand what I’m doing. I may tell them, “It might feel […]

2026-09-22T09:45:09-04:00September 22nd, 2026|Nursing, nursing roles|0 Comments
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Community Hospital Closures: Raise Your Voice

In my Ohio county, two of our three hospitals have closed since 2025. Here’s what happens when first responders are stretched beyond their limits. In June, 2025, I may have lost a good friend because of delay of care after he was stung by paper wasps in his backyard. He made it into the house where his wife gave him an EpiPen injection, called 911, and gave him two Benadryl tabs. When she went for a glass of water, he lost consciousness.

Minutes passed. She called 911 again and asked where they were. “Oh, we patched that over to the next township,” she was told. “Both of our squads are out on other runs.” His wife is a small woman and did not know CPR. His breathing slowed, his color became dusky, and then he quit breathing. More time passed. When the squad finally arrived, they assessed, quickly put him on the floor, intubated, started a line, CPR, AED, all of that. He was in pulseless electrical activity and never regained consciousness.

They transported him to the now closest hospital, which was nearly 16 miles away. His wife called me when they were en route and said, “I think he’s already dead.” We were […]

2026-09-08T11:18:48-04:00September 8th, 2026|Nursing|0 Comments
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One Question That Can Change the Diagnosis: Why Travel History Matters

A college student presents to the emergency department with fever, nausea, vomiting, and diarrhea after returning from a spring break humanitarian mission trip to Haiti. During the nursing assessment, the patient reports having brushed their teeth with water that might have been untreated and recalls receiving multiple mosquito bites. What might at first appear to be a routine case of gastroenteritis comes in this case with concern for dengue, malaria, typhoid fever, or cholera. The patient’s travel history changes not only the differential diagnosis but also the urgency of testing, treatment, and infection-control decisions.

One simple question can change a patient’s outcome: Have you traveled recently? According to the CDC, nearly half of travelers to low- and middle-income countries become ill during or after travel. Although many illnesses are mild, some require hospitalization, and others may not become apparent until weeks or even months after returning home. Some syndromes can present years after travel.

Why travel matters.

According to the WHO, international travel is on the rise. Millions of people are traveling for professional, personal, and humanitarian reasons. International travel exposes people to infectious diseases that may be uncommon in the United States. Contaminated food and water, insect bites, animal exposures, health care […]

2026-08-28T09:50:45-04:00August 28th, 2026|infectious diseases, Nursing, Public health|0 Comments
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‘Brain Rot’ in Nursing Students: And Other September Issue Highlights

The September issue of AJN is now live.

Here are some highlights. Some articles are open access or temporarily free; others will require log-in for access.

The painting on this month’s cover evokes the power of the mind. It’s a nod to “AI Dependency and Brain Rot Among Nursing Students: A Mixed-Methods Study,” in which Sağlam and Kalanlar surveyed and interviewed undergraduate nursing students to explore the relationship between excessive use of AI tools and “brain rot,” or cognitive deterioration associated with overconsumption of digital technologies and online content. The authors note that the concept of brain rot “remains largely unrecognized by nursing academia, despite its potential to influence cognitive, emotional, and behavioral domains.”

Pediatric fractures are a common reason for ED visits, yet distinguishing accidental injuries from those caused by physical abuse remains a complex clinical challenge. The September CE article, “Beyond the Spiral: Identifying Abuse-Related Pediatric Fractures,” clarifies common misconceptions, such as that all spiral fractures are inherently suspicious, by situating them within the broader evidence base related to pediatric orthopedic injury.

The latest article in our Evidence-Based Decision-Making Series, “Dissemination: Sharing the Story,” presents dissemination as a core competency for DNP students and shows how dissemination can be intentionally integrated […]

2026-08-24T10:05:28-04:00August 24th, 2026|Nursing|0 Comments
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E-Bikes and Kids: Permission Is Not Preparation

When a student returns to my middle school after an e-bike or e-scooter crash, the emergency may be over, but the injury is not. I see the cast and crutches, the concussion plan, the missed classes, the headaches that linger, and parents still trying to understand how an ordinary ride changed so much. That is why “Are you ready to ride?” must mean more than having permission to leave the driveway.

I have been a nurse for more than 30 years, the last 11 of them as a school nurse. I am not usually the nurse at the crash scene. I am the nurse who sees what comes next. I see the student navigating hallways on crutches. I see the child who insists the headache is gone because they are tired of missing gym or practice. I see the parent coordinating appointments, transportation, schoolwork, and recovery while wondering when life will feel normal again.

Outside our schools, the change arrived silently. Dismissal once meant the rumble of buses, parents calling through open car windows, and the rattle of bicycle chains. Now students glide away with a quiet electric hum, heading to practice, work, friends’ homes, and the growing independence every generation of teenagers has wanted.

That […]

2026-08-12T15:41:12-04:00August 12th, 2026|Nursing, Public health, school nurses|0 Comments
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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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