About Jacob Molyneux, senior editor/blog editor

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

Overcoming Barriers to Kidney Transplantation

By Genevieve Coorey, BSN, MA(Ed.). Coorey is the quality assurance and program director at the National Kidney Foundation and was the lead author of “Barriers to Preemptive Kidney Transplantation,” published in the November issue of AJN.

 

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Talk with any nursing colleague who cares for people with a chronic, complex disease and you will hear about the resilience and patience with which they accept—even triumph over—the effects of their illness.  

Cheryl learned nine years ago that her kidneys were failing. “At one point, I was so weak from anemia and malnutrition I could barely lift a dinner plate. Walking through a grocery store was a struggle. I used a wheelchair briefly because my legs were so filled with fluid. My husband . . . had to carry me at times, because I was too weak to walk.” 

A long-time school friend gave Cheryl one of his kidneys. She took up biking when her recovery allowed and the next summer she rode a 69-mile segment of a huge annual bike ride across Iowa; two years later she rode all 500 miles. Now Cheryl is a seven-time gold medal winner at three separate National Kidney Foundation U.S. Transplant Games events and a two-time bronze medal winner at the World Transplant Games. Extraordinary.

2016-11-21T13:21:07-05:00November 12th, 2009|nursing research|5 Comments
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Saving SimBaby – Teaching Nurses to Speak Up

AJNReportsNov09The baby’s condition is going downhill fast. A medical team surrounds the infant, tersely exchanging instructions. The gripping scenario has the participants’ hearts beating fast, but the baby on the table is SimBaby, a manikin with sophisticated robotics that’s used in health care simulation training.

As in a real situation, “there is adrenalin in a simulation,” explains Elaine Beardsley, MN, RN, clinical nurse specialist in the pediatric simulation program at Seattle Children’s Hospital. “Even though it is a simulated environment, people get nervous. People talk more.” However, Beardsley says, the structured communication training within the simulation “cuts the chatter.”

The November AJN Reports focuses on ways that SimBaby is helping teams of nurses and physicians at Seattle’s Children’s Hospital learn to avoid the kinds of communication breakdowns that, studies have shown, can lead to errors in stressful situations. The training includes creating a safe environment in which nurses and residents are encouraged to speak up to physicians “when they perceive mistakes being made.”

“Simulation, in my mind, is about getting us to communicate better,” says Jennifer Reid, MD, assistant professor of pediatric emergency medicine at the University of Washington School of Medicine and Seattle Children’s Hospital and codirector of the hospital’s ED simulation program. “Our training is such that physicians and nurses are usually educated, trained, and practice more or less in parallel. Simulation is an opportunity-a rare one-for us to learn and train together, working consciously on our communication skills. When else do I […]

2016-11-21T13:21:09-05:00November 11th, 2009|students|1 Comment
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‘Mercy,’ Revisited: A Nurse Goes from Harsh Critic to Fan

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By Peggy McDaniel, BSN, RN

The new NBC television series Mercy is starting to grow on me. Like some other recent shows (Nurse Jackie and Hawthorne), this drama features nurses as the lead characters. As I explained here a while back, my response to the first episode was very negative. Disparaging comments made about nurses by other staff and by patients’ family members struck me as unnecessary and irritating. Lines like “what do you know, you’re only a nurse?” were hard for a real nurse to take. My first impression was that the characters could have been women in almost any career. The words and actions of Veronica, one of the lead characters, seemed harsh and inappropriate. The overall image of nursing was negative.

So now for my confession: I have continued to watch Mercy. And I’ve become less of a critic and more of a fan. We still get more dramatic effects than convincing reality. For example, in a recent episode, Veronica runs in and bangs a patient’s chest with her fist, an action which ultimately restarts the patient’s heart. I still miss the comparatively realistic practices depicted in ER; Mercy doesn’t attempt to get such details right. 

But recent story lines have shown our nurse heroines to be strong patient advocates. This is a true (believable, and inspiring) nursing role. Even if the story line takes liberties with what a real nurse would do—such as when a character visits a patient’s son at his home to encourage him to visit his dying mother—the point about patient advocacy is made and appreciated. Advocating […]

2016-11-21T13:21:12-05:00November 10th, 2009|nursing perspective|1 Comment
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Are Domestic Violence and Pregnancy Preexisting Conditions?

By Peggy McDaniel, BSN, RN

Kaiser Health News recently ran a story about an attorney who was denied private insurance coverage based on a “preexisting condition”—that is, treatment she’d received following a domestic abuse incident. A majority of states have passed laws prohibiting insurers from denying coverage based on treatment for domestic violence, but  eight states as well as the District of Columbia have no such legislation. It is a challenge to track the occurrence of such denials. Insurers often use alternative ways to find out about a history of domestic abuse. They have been known to search for protective orders at local courthouses, which is public information, and search through medical records for documentation of treatment related to such incidents. 

A bitter irony is that nurses are expected to be aware of and directly question patients about suspected abuse, yet in doing so we could be setting up patients for future loss or denial of coverage. 

Pregnancy, likewise defined as a preexisting condition, can also be used to deny coverage. Health reform bills under consideration would disallow the practice of basing insurance rates on gender, a practice which has in effect discriminated against women, particularly those of child-bearing age. 

The practice of denying private health insurance coverage based on these and other preexisting conditions must stop. As a nurse and a consumer, I believe that everyone should be able to buy health care at a reasonable price. A rate such as $1,000 per month for a family is not affordable. In the end we all pay if people do not have some […]

2016-11-21T13:21:15-05:00November 6th, 2009|health care policy, nursing perspective|2 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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