About Jacob Molyneux, senior editor/blog editor

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

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?

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.

 

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 […]

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 […]

2016: An ‘Unbelievable’ Year

“When I think about 2016, one word that keeps coming to mind is ‘unbelievable.’ It’s a word I’ve found myself using many times over the past year, often while shaking my head in disbelief.”

That’s the opening of AJN editor-in-chief Shawn Kennedy’s January editorial. In it, she lists serious public health challenges facing this country and the ways political considerations get in the way of acting in the public’s best interest—whether in relation to gun violence, funding to fight infectious disease threats, the ever-increasing cost of essential medications, or health care reform. Too often lies and distortions are now treated by people who know better as the equals of truth and fact.

But you probably have your own list of ‘unbelievable’ things that happened in 2016, perhaps some of them hopeful. Click the above link to read the article, which is free.

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