When Good Nurses Make Mistakes

The next day, as I prepared my medication tray with shaking hands, two physicians sat at the nurses’ station, talking too loudly as they discussed the medication error and wondered which nurse had made it. Overhearing them, I turned to confess, feeling like a marked woman. They muttered something in my direction, shook their heads, and quickly returned to their charting.

That’s an excerpt from fairly late in “Roger’s Angst,” the Reflections essay in the April issue of AJN. It explores the crippling shame, anxiety, and self-doubt that good nurses can feel when they make mistakes. And it suggests that no one, however conscientious they may be, is free from error in a long career—though few ever reveal their little secrets, even if we might all gain from the knowledge. A touchy subject, to say the least; we hope you’ll read the entire essay and consider weighing in with your own experience. Anonymous comments are, as always, fine.—JM, senior editor/blog editor

Bearing Witness: April’s ‘Art of Nursing’ and Cover Art

By Sylvia Foley, AJN senior editor

In “Palm Sunday,” the poem featured in this month’s Art of Nursing, nurse and poet Rachel Betesh evokes the prolonged anguish of those who tend the dying. A man lies “sick and stained” in a bed, leaves his food untouched, and “hardly speaks anymore.” His wife and sons lament “the sin of the too-long moment”; time does not heal, but gapes like an “open wound between sickness and dying.”

A lesser poem might have slipped into sentimentality. But Betesh’s characters are a lively, indomitable bunch. “Pop!” the man’s sons say, visiting; you can feel their vigor. His wife remembers a baked potato he’d once given her, and her response: “You gonna marry me or what?” Indeed, it’s through witnessing, hearing the family’s stories, that the nurses can offer some comfort. They cannot heal the man, but they can “pack the wound, and listen.” (Art of Nursing is always free online—just click through to the PDF file.)

This month’s cover art, a work of embroidery by nurse and fiber artist Paula Giovanini-Morris, explores the concept of memory and illustrates its mechanisms, the neurons and synapses through which the brain registers, encodes, and retrieves events. The piece, titled “Windows and Doors,” was prompted by another kind of witnessing: the artist’s visits to her mother, who was suffering from the early stages of dementia.

AJN senior editorial coordinator Alison Bulman spoke with […]

Same Boat, Different Ocean

By Shawn Kennedy, AJN editor-in-chief

Since the Robert Wood Johnson Foundation/Institute of Medicine Future of Nursing report was released six months ago, we’ve heard a lot about how nurses need to have more representation on boards of health care institutions and be more active participants in decisions about redesigning health care delivery systems. (See our online resource page for a variety of information about the report.)

To me, it’s a recommendation that’s so intuitive and simple that it’s almost embarrassing—and the need for it only drives home how absurd our health care system can be. It’s mind-boggling to me that organizations feel they can plan effective health care without the input of nurses. Imagine aircraft manufacturers designing a plane without input from the primary group—pilots—who will be responsible for flying it safely.

I suppose many health care entities and boards  feel that they have this input from physicians—but really, in most hospitals physicians aren’t involved in the nitty-gritty operations details that either make or break workflow processes or can impede the delivery of safe, cost-effective care.  How many times have hospitals planned patient care units or purchased equipment without nursing, input only to find that the systems aren’t workable or create more work? […]

Nurses, Summits, and Salt Lake: The Challenges Facing New Nursing Grads

By Shawn Kennedy, AJN editor-in-chief

I’m attending the National Student Nurses’ Association (NSNA) annual convention, in Salt Lake City, Utah. I always gripe about meetings here—but then I arrive and realize I’d forgotten what a beautiful place it is. For one thing, there are the mountains rising up behind the cityscape—everywhere you look, there they are. (The photo here was taken from the plane as it was approaching Salt Lake City.)  There’s something really relaxing about these views.

I always enjoy this conference—I love meeting the future generation of nurses. This year’s group—about 2,400 strong—are enthusiastic, passionate, and serious about a career, not just a job. Many are people who’ve already been in the workforce. According to figures from the NSNA about the attendees, 47% are 26 or older, 22% are 36 or older, 52% will be graduating from baccalaureate programs, and 93% plan to continue their education. Impressive statistics.

Yesterday’s keynote speaker was Patrick Hickey, a professor at University of South Carolina–Columbia School of Nursing, who has summited the seven highest peaks in the world. He spoke about the challenges of his climbs, especially Mount Everest, where he spread the ashes of a friend who was supposed to have been with him. It was fitting—here, with mountains all around us, and with many in the audience facing their own uphill climb […]

Nursing and Women’s Basketball Go Back a Long Way

Nursing Student Basketball Team, Grace Hospital, Detroit, 1924

By Maureen ‘Shawn’ Kennedy, AJN editor-in-chief

I’m a big college basketball fan (to me, professional teams seem less about the team and more about the players). When I was growing up in the city, playground basketball was the only sport that was accessible on a daily basis. (OK, there was a ping-pong table, but that just didn’t seem as exciting.) I learned to play the game there, and then played in high school and for one year in college as a freshman. After that, nursing classes and a part-time job interfered. More recently, I coached grammar school and middle school girls teams (one of the funnest things I’ve done!).

I love that the women’s NCAA college basketball tournament has received more and more coverage each year. A few years ago, one was hard-pressed to find out when the games were being televised. Now, they’re enjoying prime time, if not a prime channel. (Women’s games—and tonight’s championship game between Notre Dame and Texas A&M—are usually broadcast on cable, on ESPN.)

So here’s some trivia: many people may not know that most nursing schools had basketball teams in their early days—as far back as the 1920s. It’s always been interesting to me that, despite the oppressive and convent-like restrictions placed on nursing students, these young women could play basketball! There were leagues among schools—the AJN archives has articles and photos of early teams (the photo above shows the team […]

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