About Jacob Molyneux, senior editor/blog editor

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

A Crucial Public Health Lesson: Let the Women Speak

” . . . people have their own hope and power which they need to discover.”

Illustration by Gingermoth for AJN.

Do some public health projects fail to live up to their ambitions because they were conceived in a conference room rather than in dialogue with those they are trying to help? It seems possible. Terms like client or community “buy-in” are now fashionable, but maybe what’s really meant by such terms is that people are given a chance to state their needs and their concerns ahead of time. And that someone is listening.

In this month’s Reflections essay by nurse practitioner Mark Darby, he remembers a valuable lesson once imparted to him through example by a Dominican priest. “Shut Up and Let the Women Speak” doesn’t flatter the younger version of the author who once visited the Dominican Republic on a medical mission. […]

2017-12-11T08:37:50-05:00December 11th, 2017|Nursing, nursing stories, Public health|0 Comments
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Through Song, a Nurse’s Renewed Connection to An Ailing Mother

Illustration by Barbara Hranilovich for AJN.

Millions of Americans are now acting in some capacity as caregivers for an ailing parent. This month’s Reflections column is by a nurse who describes a moment in time as she helps to care for her home-bound and dying mother. Her mother remains, on occasion, as judgmental and offputting as the mother of her childhood.

But in such cases, there’s little to gain by dwelling on old disappointments and hurts—and in this instance, there are good memories as well.

The common language of song.

These good memories are primarily associated with her mother’s love of and talent for singing. “Moon River and Mom” describes this nurse’s experience of tending her mother’s leg wound as the Meals on Wheels man visits, and what happens afterward when the author prompts her mother to sing. […]

2017-11-03T07:50:46-04:00November 3rd, 2017|family experience, Nursing, nursing stories|0 Comments
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Easy to Judge Patients for their Choices, Harder to See Them as Individuals

This month’s Reflections essay, “Someone’s Son,” is by Jami Carder, now an RN case manager at the Visiting Nurse Association of Cape Cod. In it, she looks back to a formative nursing experience.

I started my nursing career as a floor nurse. Our patients were complex, and though it seemed we never had enough time or staff, it was important to give them the care they needed and deserved…. [I]t was frustrating to feel that any time was being ‘wasted’…. I remember complaining, at such times, about not being able to take care of my other patients who were ‘really sick.’

By Eric Collins/ecol-art.com.

Who ‘deserves’ care?

Wasted here is meant as code for spending valuable patient care time on patients who are sick because of unhealthy behaviors: in this essay, substance abuse. But we might also then include smoking, overeating, lack of exercise, and so on.

The potential list of unhealthy behaviors is long. And the question of choice is slippery, to say the least. It’s always before us in our personal lives, moment to moment—and by extension, for nurses at the bedside, and in how we as a society think about health care and who ‘deserves’ it. […]

2017-10-11T12:17:07-04:00October 11th, 2017|Nursing|0 Comments
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Hospital Closings Hit Rural Communities Hard, But Aren’t Inevitable

Photo by Taylor Sisk/North Carolina Health News

Community hospitals across the country have been closing in recent years. Reasons given include system consolidations, rising costs of care, Medicare reimbursement issues, and changing models of health care delivery. Few hospital closures are welcomed by patients or employees, but those that take place in rural areas, where there may not be another hospital for many miles, often affect the local community with particular severity.

A double hit for local economies.

Not only do hospital closings in rural areas make access to health care a challenge, sometimes forcing local residents to drive many miles for care. But—as this month’s AJN Reports points out (“Will Rural Community Hospitals Survive?“)—rural hospital closings also have a ripple effect on a local economy, meaning lost jobs as well as lost revenue for ancillary businesses in the area.

Hospital that innovate may survive.

Despite current pressures, some rural hospitals are finding new ways to thrive. As the article describes in greater detail, hospital “survival strategies” include partnerships and “becoming increasingly creative with providing services,” including expanding the use of telehealth. […]

2017-09-26T09:45:27-04:00September 26th, 2017|Nursing|0 Comments
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When a Patient Turns Scary, a Nurse’s Options Aren’t Always Clear

I was leaning over my patient, listening to his lung sounds, when his hand tightened around my wrist. “Why don’t you get in the bed with me?” he said.

Illustration by McClain Moore

That’s the arresting opening of “The Squeeze,” the Reflections essay by nurse Danielle Allen in the September issue of AJN. Such scary experiences happen, as many nurses can attest. What behaviors cross the line? Who decides? After all, nurses put up with lots of challenging behavior. What’s unacceptable, and what constitutes a real safety issue?

Complicating these questions may be the responsibility a nurse feels to not let down their equally burdened nursing colleagues. No one, as Allen writes, wants “to be that nurse. You know, the complainer, overly sensitive, not-a-team-player nurse.”

Allen vividly evokes her encounter with the patient, the varied responses of nursing colleagues later, the emotional aftereffects of the event, and the larger question she finds herself asking about what can be done to keep nurses and other health care workers safe. […]

2017-08-28T08:37:02-04:00August 28th, 2017|Nursing, nursing stories|1 Comment
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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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