Nurses and Patient Safety: Parallel Histories

Photo from AJN archives.

I’m especially pleased that one of the CE articles in the February issue focuses on nursing’s role in creating a safe environment for patients: “Nursing’s Evolving Role in Patient Safety.” And in full disclosure, I was excited to see that the authors used the AJN archives to chronicle how nursing addressed (or didn’t address) safety issues around patient care.

From the earliest days of nursing through to the current complex systems in which we practice, nurses have been the health professionals responsible for ensuring safe passage of patients through the health care system. From Nightingale’s criteria for creating a healing environment to the “5 rights of medication administration,” patients rely on nurses to act as sentinels.

The authors reviewed 1,086 AJN articles from 1900 to 2015 and conducted a content analysis to identify patient safety themes. Aside from uncovering many fascinating (and sometimes alarming!) details of former health care practices, the authors drew this general conclusion:

“Emphasis on patient safety increased as patient care became more complex. As nurses developed a professional identity, they often put a spotlight on safety concerns and solutions.”

Here’s a quote from a nurse who wrote in 1908 about […]

The Role of Prevention and Standardized Care in Improving CKD Outcomes

Slowing Chronic Kidney Disease Progression

Most nurses have worked with patients with chronic kidney disease (CKD). Their condition may have been related to diabetes, high blood pressure, an acute infection, or other assaults on the kidney. I’ve tended to see a diagnosis of CKD as the beginning of an inevitable decline. Certainly, “prevention” didn’t seem a relevant concept at this point; my role was to assess and monitor, teach and support, and hope for the best.

Fig. 1. The Nephron. Blood flows into the nephron through the glomerulus. Filtrate from the glomerulus flows into Bowman’s capsule, then through the proximal tubule, the loop of Henle, and the distal tubule, a series of tubules that modifies the filtrate primarily by reabsorbing water and needed electrolytes into the bloodstream. The modified filtrate (urine) then flows into the collecting duct and eventually drains into the renal pelvis. Courtesy of National Kidney Disease Education Program and the NIDDK.

However, the authors of the February CE feature, “Improving Outcomes for Patients with Chronic Kidney Disease,” make it clear that many of us (nurses as well as physicians) aren’t up to date about what we can do to slow the […]

February 15th, 2017|Nursing, Public health|0 Comments

Ann Burgess: Forensic Nursing Pioneer

Ann Wolbert Burgess, DNSc, RN, APRN-BC, FAAN. Photo courtesy of Caitlin Cunningham Photography.

Last fall, Ann Wolbert Burgess was named a Living Legend by the American Academy of Nursing. It’s a fitting honor for a nurse who has spent decades studying victims of trauma and abuse and the perpetrators of those crimes, in addition to working alongside the FBI and testifying as an expert in the courtroom. She has also written numerous articles and books and currently teaches forensics at Boston College.

Burgess earned her doctorate in psychiatric nursing from Boston University, and thought she’d ultimately be a nurse psychotherapist—but her career path took a different turn than she expected. In the early 1970s, motivated by the feminist movement, Burgess and her colleague Lynda Lytle Holmstrom started one of the first hospital-based crisis counseling programs for rape victims, at Boston City Hospital.

The program enabled nurses to provide counseling to rape victims, and allowed Burgess and Holmstrom to conduct research on rape victimology. Their research led them to write a groundbreaking paper in 1974 that introduced what they called “rape trauma syndrome,” describing its […]

February 13th, 2017|career, Nursing|2 Comments

Nursing Stories: Celebrating a Family Matriarch’s Life as Death Approaches

Illustration by Gingermoth for AJN. All rights reserved.

In this month’s Reflections essay, “Helen’s Family,” a home health nurse remembers a family that was not ashamed to celebrate life around a beloved matriarch even as her death approached.

The author, Cyndy Irvine, understands the crucial and difficult role played by family caregivers, who were “often partners in caring for” her patients:

. . . Some situations were not so difficult for them, perhaps a course of IV antibiotic therapy for osteomyelitis, or a posthospital assessment of medication compliance and mobility issues; others were more daunting, such as the last stages of an incurable disease.

The timing of Helen’s illness was not convenient—the march of family responsibilities carried on in the lives of her children, yet they recognized her final weeks and days as a sacred part of her life, and of their own.

Every family has a style, an energy, a way of relating or not relating. The author finds something special in this family’s efforts to fill “Helen’s” home with laughter, beauty, and a kind of celebration. The essay is rich in sensory details, and pervaded with a poignant awareness of the gift of life, even when it’s most fragile and in question. To read this one-page essay, which will be free until February 24, click here.

 

February 10th, 2017|Nursing, Patients|0 Comments

Black History in AJN: From Booker T. Washington To Today’s Influential Voices

Black nurses at Camp Sherman, Chillicothe, Ohio, in 1918.

Acknowledging Black History Month

February is the month designated for remembering the contributions of black people to our nation and our culture. It’s a good reminder that in nursing, too, we have benefited from many strong black women (and at least a few men), who often persevered in the face of discrimination in obtaining education and jobs.

The AJN archives have several articles worth revisiting.

This article from 1976, “Black Nurses : Their Service and Their Struggle” (to read, click on the pdf), describes the struggles of several of our profession’s notable black nurses, including Mary Mahoney (the first black nurse to be licensed).

In a 2010 editorial, Alicia Georges, professor and chairperson of the department of nursing at Lehman College of the City University of New York, writes, “We all stand to benefit from the active participation of black nurses in our communities and our lives.”

A 2013 commentary by Kenya Beard (an AJN editorial board member) and Kellie Voicy speaks to the need for increasing minority representation in nursing.

And a jewel: an article by Booker T. Washington, published in 1910, on nurses’ training at Tuskegee.

The above articles will be free until March 1. Please read them and become informed and inspired.

February 8th, 2017|Nursing, nursing history|0 Comments