About Jacob Molyneux

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.

When a Family’s Faith in Healing Collides with a Busy Hospital Unit’s Pressures

Illustration by McClain Moore for AJN/all rights reserved.

What happens when a family of strong religious faith is determined to continue praying for a young father’s healing even after he dies of a terminal brain tumor in the MICU? The room is needed for other patients; a nursing student and her preceptor cared for the patient during his final hours of life and are now expected to provide postmortem care.

It’s a tricky, somewhat tense situation, and initial reactions among the nurses in the hospital vary. Melody Sumter, the author of this month’s Reflections  (“A Place for Faith: My First Experience of Cultural Competence in Nursing“), was the nursing student assigned to the patient, who left behind a young wife and 10-month-old child.

Looking back on the event, Sumter recalls her competing sympathies at the time, and the way she was gratified to learn that the nursing staff at last found a way to honor the wishes of the patient’s family and also see to their responsibilities to other patients. Writes Sumter:

Seeing this family practice their faith was encouraging for a young nursing student like myself—as was the nursing staff’s acceptance and support of a belief that most of them didn’t understand.

The author […]

Just a Nurse, or a Bedside Leader? Mental Models Can Be Changed

If you haven’t read the Viewpoint column in the March issue of AJN, “Just a Nurse, or a Bedside Leader?“, we recommend it. The author, Amy Constanzo, director of nursing administration at University of Cincinnati Medical Center, puts into eloquent words one of the central “unthought knowns” in the daily experience of many nurses. Constanzo writes:

“Despite the Institute of Medicine’s Future of Nursing report that calls for nurses to be ‘full partners, with physicians and other health professionals, in redesigning health care in the United States,’ the mental model of ‘just a nurse’ is still out there, inhibiting potential.”

But she’s not pessimistic. She believes “just a nurse” is a mental model like any other, and mental models can be changed—but only if you make it your quest to do so. Constanzo proposes an alternative mental model for nurses: “I am a nurse.” On the surface, it’s a simple statement, but it’s also, she believes, a statement of both strength and possibility:

“When you say ‘I am a nurse,’ you are claiming the values of nursing and your contribution to assisting patients in achieving their best level of health. To do so requires a clear vision of nursing as a profession and of nurses’ contribution to the health care team.”

How do you describe your work as a nurse—to yourself, and to others?

2017-03-03T13:18:26+00:00 March 3rd, 2017|Nursing, nursing perspective|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.

 

2017-02-10T11:45:50+00:00 February 10th, 2017|Nursing, Patients|0 Comments

A Public Health Nurse at the Intersection of Birth and Death

by Lisa Dietrich for AJN/ all rights reserved

The January Reflections essay in AJN is called “Touching Death, Touching Life.” The author, Yaffa Vinikoor, is a public health nurse who describes a patient she refers to as Sidney. Over time, she’s come to know the worn furniture of Sidney’s small apartment and the details of his life, such as Arnold, his paid caretaker, and Sidney’s younger wife, who lives separately. Sid has dementia and several other conditions and is in decline. “Sid,” she writes “usually lay slanted, like he’d been haphazardly dropped onto the enormous mattress, hair askew and face contorted.”

The essay explores what it’s like to be pregnant while doing such work. Vinikoor’s situation that summer puts her in relation to two very different currents:

I continued to do my work in the city as a public health nurse with the chronically ill homebound up until the day I went into labor. . . . I continued to walk miles per day, the nursing supplies in my backpack bowing my back and the baby in my belly guiding me forward . . . . As I cared for those whose lives were in steady decline, I thought about what giving birth to new life would be like.

[…]

2017-01-27T10:31:16+00:00 January 27th, 2017|Nursing, nursing stories, Public health|2 Comments

As ACA Under Threat, Dawning Awareness of a Law’s Many Provisions

by matsuyuki/via Flickr

Nurses reflect the American population’s variety, and this means that many nurses support the Affordable Care Act (ACA) and many would like it repealed, whatever the replacement might be.

Like many Americans, nurses may have a broad ideological or analytical perspective on the pros and cons of the ACA or other health policy issues. Or they may choose for or against complex legislation on the basis of a single issue—like abortion funding, or insurance access for a husband or daughter with a preexisting condition, or whether they believe staffing issues can be blamed on their hospital administration or an ACA provision.

But it’s been my experience as an editor at AJN and a citizen that many people don’t really know that the ACA has multiple provisions that address quality and access issues at every level of health care.

The futures of these provisions are all in question as the Trump administration and a Republican-led Congress prepare to hack away at the ACA without a clear replacement plan.

With a kind of pre-obituary fervor, the media is beginning to pay attention to the changes the ACA brought about now that many may soon disappear—so, for seemingly the first time, are many Democratic politicians, who it’s now clear did very little to sell the ACA to their constituents. With that in mind, might […]

2017-01-20T09:12:42+00:00 January 20th, 2017|health care policy, Nursing|5 Comments