What One Thing Will Make Today Better for You?
As I entered Mr. Ricker’s room, I remembered that the night nurse had mentioned that his wife had been with him overnight. I knocked very lightly and opened the door a crack. The two of them were cuddled up closely in the bed.
“What One Thing Will Make Today Better for You?” That’s the title of the Reflections essay in the September issue of AJN, in case you thought a genie had materialized out of the steam from your afternoon coffee mug. A simple question, but one that author Susan Goff has used since the 1970s with her patients. Sometimes the answer is surprising—that is, sometimes we shouldn’t assume we know what patients want . . . or need. Sometimes, in the case of the patient she describes in this essay, there’s something that should trump NPO. We hope you’ll read the essay and let Susan know your thoughts in our comments section below.—JM, senior editor
Remembering 9/11: Nurses Were There
By Shawn Kennedy, editor-in-chief
One can find many commemorative events for the 10th anniversary of 9/11 being held in those places (New York City, Washington, DC, and Shanksville, Pennsylvania) where planes hit, and in other cities as well. Some are appropriate and done well and others are (at least to me) over-the-top and tactless—like one New York City radio station playing tapes of the confusion and chaos from first responder radio transmissions; families and friends of victims don’t need to hear that and think of what their loved ones were going through in their final moments.
How we saw it then. AJN’s offices are located in New York City. In 2001, we could see the burning World Trade Center from our windows and we wrote about about our experiences and thoughts. We knew nurses would be in the forefront of responding to help, so we reached out to nurses here in New York and in the Washington, DC, area in order to report on what nurses there were doing. And we also carried a Viewpoint essay, in which one of our Muslim colleagues reported on the backlash that she was experiencing and made a plea for tolerance.
Our current coverage. In planning this September issue, we wanted to acknowledge the events in some way—hence our cover (thumbnail illustraton above) by artist and nurse Charlie Kaiman, who witnessed the events (see also his artwork from 2001 conveying that […]
Killing Traditional Nursing Duties #2
Editor’s note: In early August, on our Facebook page, we asked if there were “old nursing habits” that should be killed off. We received a lot of feedback, which we described in a blog post, “Killing Traditional Nursing Duties #1.” We’re back now with feedback from our second question: “When you give IM injections, what site do you most often use—dorsogluteal (upper outer quadrant of
buttocks), ventrogluteal (lateral hip), or deltoid (upper arm)? Why?”
Hands down, the deltoid injection site was preferred for intramuscular (IM) injections, especially for immunizations and if the patient was an adult. (“People don’t have to drop their drawers” was my favorite reason cited.) A few of those who favored that site noted that, if they didn’t use the deltoid (because of the volume of the injection), they would then go to the ventrogluteal site. One person preferred the vastas lateralis (the outer middle third of the thigh), which wasn’t listed as a choice, but is certainly a site that’s used, especially in infants. And several respondents said they prefer the dorsogluteal site. Reasons given were “more comfort” and “more muscle.”
This is actually contrary to current evidence and teaching, which is that the preferred site is the ventrogluteal site. As noted in an article we did in February 2010, evidence indicates we should avoid the dorsogluteal site because “it poses unnecessary and unacceptable risks of […]
Caring for Suicidal Children in the ED
By Sylvia Foley, AJN senior editor
Suicidal children and adolescents are often first seen in EDs. At Children’s Hospital Boston (CHB) recently, a boy we’ll call J.J. was one of them. Still in elementary school, he had just started a new school year. J.J. has Asperger’s syndrome (a disorder on the autism spectrum), and new situations are difficult for him. His classmates were teasing him, and it was escalating: one boy reportedly threatened to kill J.J. for being “weird.” Despite efforts by J.J.’s parents and the school to address the situation, J.J. became increasingly depressed and fearful. As September CE authors Alexis Schmid and colleagues explain,
On the morning of the ED visit, as the family members were starting their day, J.J. had gone into the kitchen, found a butcher knife, and held it to his throat. His mother walked in and saw him. Although J.J. willingly surrendered the knife to her, she said she was “rattled to the core.”
Schmid was the ED nurse on J.J.’s case that day (all three authors work at CHB). In “Care of the Suicidal Pediatric Patient in the ED: A Case Study,” the authors describe the course of J.J.’s care and what they did to keep J.J., his family, […]