December 2010 - Page 2 of 3

‘At the Night Camp’: How Assumptions About Patients Can Blind Us

The entire time he was with us he kept looking around, eyes darting back and forth and toward the truck he’d driven, which he told me wasn’t his own. He shifted uneasily in his chair, and I felt the impulse to try to comfort him and tell him we could help.

That’s an excerpt from “At the Night Camp,” the December Reflections essay in AJN. The essay, by Meg Sniderman, a student in the MSN program at Emory University School of Nursing in Atlanta, takes a wry, honest look at the ways we can imagine whole lives for those around us based on their cultural identifiers, yet often miss the most obvious things about these patients . . . the things that make them just like us, despite apparently vast cultural differences.—JM, senior editor/blog editor

Jacob Molyneux, senior editor/blog editor2016-11-21T13:14:39-05:00December 17th, 2010|nursing perspective, patient engagement, Public health, students|0 Comments

Amazing and Disheartening: How We Continue to Fail Family Caregivers

By Shawn Kennedy, AJN interim editor-in-chief

Recently, as part of an ongoing collaborative initiative on supporting family caregivers with AARP (see the comprehensive, and free, AJN supplement called State of the Science: Professional Partners Supporting Family Caregivers), I listened to a group of family caregivers talk about what it’s like to care for sick parents and relatives at home.

Most of the caregivers were in their 60s and retired, and now found themselves doing the back-breaking work of being on call 24/7, attending to everything from bathing and feeding to chauffeuring to health care appointments, paying the bills, and running the household—sometimes two households, if they lived apart from the person for whom they provided care.

It was amazing and disheartening to listen to them—amazing in terms of the lengths they went to make sure they were doing the right things, and disheartening because they were mostly on their own, with little support from the health care system. And this was right from the start; all said that information to prepare for the transition from hospital to home had been lacking. For the most part, families looked to the family physician to answer questions about what they would need to do at home—nurses were hardly mentioned.

What They Said

All said they could have used better preparation before discharge; all agreed that there was little time to ask questions and that health care was “less about quality, and more about […]
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Jacob Molyneux, senior editor/blog editor2016-11-21T13:14:40-05:00December 15th, 2010|nursing perspective|11 Comments

When They Can’t Tell You About the Hurt: Assessing Pain in People with Intellectual or Developmental Disabilities

By Sylvia Foley, AJN senior editor

When S.M., a 47-year-old resident at a facility for people with intellectual or developmental disabilities, started hitting himself in the left eye, his caregivers weren’t sure why. S.M., whose developmental quotient is equivalent to that of a two- or three-year-old, couldn’t tell them. Some thought he was frustrated at not being allowed to drink as much coffee as he wanted; others thought a recent decrease in his medication—quetiapine (Seroquel)—might be a factor. But a chart review revealed that both his father and brother had a history of cluster headaches. Was S.M.’s behavior an indicator of headache pain? How could clinicians best assess him?

In this month’s CE feature, authors Kathy Baldridge and Frank Andrasik provide an overview of pain assessment in people with intellectual or developmental disabilities, summarize the relevant research, and discuss the applicability of the American Society for Pain Management Nursing practice guidelines for assessing pain in nonverbal patients. The guidelines describe various behavioral pain assessment tools, some of which might be useful with S.M. and others like him. Other assessment methods include

a search for pathologic conditions or other problems or procedures known to cause pain; the observation of behaviors that might indicate pain; and the use of proxy reports (also called surrogate reports) by people who know the person best, whether family caregivers or professionals.

S.M. was encouraged to draw himself and what the “hurt” felt like; two […]

Guest Author2016-11-21T13:14:41-05:00December 14th, 2010|Ethics, nursing perspective, pain management|3 Comments

Dr. Oz’s Sexy ‘Nurses’: Here We Go Again

By Shawn Kennedy, AJN interim editor-in-chief

In the “what could he have been thinking?” category, Mehmet Oz, MD, wins first place—well, at least, for now. I’m sure someone else will come along soon and take his place.

In case you’ve been MIA the last month, Oz became a target for nursing ire when, on his November 4 show, he danced with several women who were wearing nurses’ uniforms revealing red lingerie. The segment apparently had nothing to do with nurses, but rather weight loss through dancing, they talked about This impact diet whey review and by the end the nurses were pretty convinced about it. (So of course that would make one think of nurses with red lingerie???)

I’m hoping it was a case where he “just didn’t think”—rather than that he thought that the segment might possibly offend nurses but decided to go with it anyway. Dogged by a letter-writing campaign spearheaded by Sandy Summers of the nursing image advocacy and watchdog group, The Truth About Nursing, and from criticism from other nursing groups like the American Nurses Association, Oz apparently released a statement on December 6 apologizing, according to various news reports. However, one can’t find it anywhere on his Web site or on the Web, for that matter.

It’s always interesting to see the level of offense colleagues and others feel. Comments posted on news sites carrying the story […]

Jacob Molyneux, senior editor/blog editor2017-07-07T13:32:16-04:00December 8th, 2010|career, nursing perspective|2 Comments

Today’s Notes from the Nursosphere

As noted today by Joni Watson at Nursetopia, it’s Pearl Harbor Day, and nurses were (surprise) key players in that day’s awful events. Here’s how the post begins:

My heart was racing, the telephone was ringing, the chief nurse, Gertrude Arnest, was saying, “Girls, get into your uniforms at once, This is the real thing!”

Speaking of safety, “Top 10 Health Technology Hazards for 2011” (pdf), from the ECRI Institute, gives us a list of hospital patient safety risks that, according to the authors, “reflects our judgment about which risks should receive priority now, a judgment that is based on our review of recent recalls and other actions . . . , our analysis of information found in the literature and in the medical device reporting databases of ECRI Institute and other organizations, and our experience in investigating and consulting on device-related incidents.” These include “radiation overdose and other dose errors during radiation therapy,” “alarm hazards,” and eight others.

And now to electronic charting vs. doing it the old-fashioned way: we have a comment thread going on at AJN‘s Facebook page about whether or not EHRs save nurses time or not. Go there to comment, or leave a comment here.

Also noted: Stephen Ferrara at A Nurse Practitioner’s View wonders whether the preceptorship model is still adequate for training NPs. Or is it time for a residency model instead?