About Jacob Molyneux, senior editor/blog editor

Senior editor, American Journal of Nursing; editor of AJN Off the Charts.

Caring for the Patient You Never Had a Chance to Get to Know

“For months, we simply knew him as this often agitated, sometimes unstable, generally nonverbal, nonpurposeful patient whose actual personhood seemed, if I’m honest, unrecoverable. We didn’t even know who we were trying to recover…”

This month’s Reflections essay in AJN is by Hui-wen Sato, a pediatric intensive care nurse in California. This piece is difficult to describe because it fits no clear category; this is also what makes it alive and engaging.

In “Beholding the Returning Light,” Sato explores the the experience of caring for a patient without ever having had a chance to get to know that person. What do you feel for that patient, and how much do you invest yourself in his or her possible future?

The ‘unthought known.’

Such questions and others may exist on a subconscious level throughout an ordinary work day for nurses in a number of settings. Sato, as she traces the sequence of events, her own emotions, and the role of the patient’s family, adroitly brings them to the surface. […]

2019-11-06T13:33:46-05:00November 6th, 2019|Nursing, nursing stories|0 Comments
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What Would It Take to Make You Appreciate the Precious Moments of Your Life?

Illustration by McClain Moore for AJN.

Imagination vs. reality.

Who hasn’t thought about it from time to time, the sudden grim diagnosis, the force of the realization that all that time you thought you had to live, love, learn, explore, and change may really be finite after all? Who hasn’t wondered what you would do with the remaining time if that happened—and by corollary, what you should be doing differently now?

But that’s all in the mind and imagination. The real clarifying shock of such an experience remains out of reach for most of us—until it happens.

Collecting experiences ‘like Mario connecting coins.’

This month’s Reflections essay, “The Last One,” is by Fran Wiedenhoeft, a former nurse anesthetist in the military. In it, she describes her own reaction after she found herself, at a relatively young age, facing just such a diagnosis.

In the two weeks before the surgery . . . I threw myself with frantic determination into collecting lasts: last long run . . . , last trip to the zoo, last potato peeled, last kiss, last caress. . . . Rather than enjoying each precious moment and every last experience, I was rushing […]

2019-10-04T11:29:52-04:00October 4th, 2019|Nursing|0 Comments
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‘You Could Do This’: Heeding A Late Call to a Nursing Career

The daunting challenge of family caregiving.

Illustration by Eric Collins / ecol-art.com

“When I meet with families for the first time, I always remember the helplessness I felt as a new caregiver,” writes Linda Beall, the author of “A Clear Small Voice,” the Reflections essay in the September issue of AJN.

Beall, now a hospice nurse, is referring to the confusion she felt while caring for her mother during the week after her initial hospitalization with metastatic cancer:

I recall helping her into the car at the time of her discharge. She had difficulty taking even a few steps. Huge staples laddered down the front of her body from sternum to pelvis. She had a drain to be emptied. I had a handful of prescriptions that I took to the pharmacy, not really knowing what the meds were.

Beall was not yet a nurse at that point. In fact, she didn’t graduate from nursing school until age 47. What spurred her to consider beginning a nursing career far later in life than most?

A clear small voice, easily missed.

In this engaging essay, she describes the experience of caring for her dying mother, and how, in the midst […]

2019-09-16T07:46:02-04:00September 16th, 2019|Nursing|0 Comments
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A Health Care Proxy and an Act of Moral Imagination

“What would Joanna have wanted?” the ICU fellow (Dr. Smith) asked Sam, Joanna’s nephew and health care proxy, for the second time this week. Sam considered the question, furrowed his brow, and said, “I still don’t know, doc.”

The human costs of indecision.

Uncertainty can at times be better than false certainty. This may even be so, up to a point, when a loved one is on life-support and subject to invasive and painful procedures. It takes time to absorb the reality of a situation.

But any nurse can tell you that, at some point, indecision becomes a decision in itself, one that can lead to many unwished-for consequences.

Seemingly unanswerable questions.It

The quotation at the start of this post is from this month’s Reflections essay, “What Joanna Would Have Wanted” (free until July 15). The story, by nurse Jennifer Chicca, MS, RN, evokes the overwhelming sense of responsibility faced by a thoughtful young man in the role of health care proxy to a beloved aunt.

How is possible to be sure what someone would want, or not want, when their end-of-life wishes have not been clearly spelled out ahead of time? […]

2019-07-01T15:50:47-04:00July 1st, 2019|Nursing, nursing stories, patient experience|1 Comment
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Daughter or Nurse? Caught Between Roles When a Father Is Hospitalized

“Word moves quickly that a patient on the unit has a daughter who is an RN.”

That’s from this month’s Reflections essay, “The Other Side,” in which a nurse struggles with her own mounting helplessness as her father’s hospital stay following surgery is unexpectedly prolonged.

On the other side.

The author finds herself in an uncomfortable in-between position, one that may be familiar to other nurses who have had family members in the hospital.

“I am an outsider, a family member on the other side. I know there is information not shared with me, information the health care team keeps to themselves. These conversations take place in whispered voices outside the room—conversations I have been a part of in the recent past, on my unit.”

[…]

2019-05-02T10:59:38-04:00May 1st, 2019|family experience, narratives, Nursing, nursing perspective, writing|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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