About Jacob Molyneux, senior editor/blog editor

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

Appropriate Use of Opioids in the Management of Chronic Pain

Painted by Martin Edwards as part of the Paint Your Pain program initiated by the Pain Management Center at Overlook Medical Center, Atlantic Health System, Summit, New Jersey. For artwork of other patients in the program, go to http://bit.ly/ 1Ns0PxL.The dangerous misuse of prescription opioids and drugs like heroin has been much in the news, but millions of patients continue to suffer both acute and chronic pain. For many, prescription opioids play a vital role in alleviating that pain. How can health care providers most effectively and safely use opioids in the treatment and management of chronic pain? Some answers can be found in a CE article in the July issue of AJN: “Appropriate Use of Opioids in Managing Chronic Pain.”

Related questions on opioids and chronic pain addressed in the article include:

AJN’s Top Five Most-Emailed Articles

IMG_2151We are sometimes surprised by the articles our readers are most interested in. The articles shared most often among colleagues are not always the articles being read by the most people. Here are AJN‘s current top five most-emailed articles, many of which deal with essential practice topics such as pain management or nursing handoffs or with various workforce and educational issues:

We encourage readers to visit AJN and explore the wealth of collections, archives, podcasts, videos, and much more. Some articles, such as continuing education features and the monthly Reflections essays, are free access; some require a subscription. And of course, feel free to let us know about topics you’d like to learn more about.

Lastly, here’s a much longer list of AJN‘s most emailed articles.

Is It Time to Retire the Term ‘Midlevel Practitioner’?

Rachel_Scherzer_photo_and_calloutWhat are the implications of calling advanced practice nurses “midlevel practitioners”? According to Rachel Scherzer, a nurse educator and critical care nurse, such a term pigeonholes APNs in an implied (and disproven) hierarchy of value and quality of care rather than in relation to specific competencies and expertise.

In the Viewpoint essay in the July issue of AJN, Scherzer describes some of the reasons why such terms aren’t just inaccurate, they damage the standing of the profession:

Policymakers use the term while developing health care policy, health care economists use it when reporting data and performing cost analyses, and other health care providers use it in the clinical setting. . . . This term is both diminutive and inaccurate, implying that these professionals cannot provide the same level of care as other members of the interprofessional care team. Referring to APNs as “midlevel” practitioners contributes to a general misunderstanding of their role and of the services they provide.

[…]

The Debriefing: A Forced Pause After an Unexpected Clinical Loss

Illustration by Barbara Hranilovich for AJN Illustration by Barbara Hranilovich for AJN

The Reflections essay in the July issue of AJN is about the brief required debriefing of a medical team after an all-consuming struggle to save a patient.

The Power of Paperwork” is written by Amanda Anderson, an experienced nurse who is new to a supervisory role. She remains closely attuned to the emotional experiences of nurses and physicians. Leading her former colleagues as they huddled to examine what might have been done differently with a particular patient, she tells us, she found that her “suit and heels provided no armor.”

Sometimes bad things happen for perfectly obvious reasons. If you don’t turn an incontinent patient, he will develop pressure ulcers. If you don’t always verify your patient’s medication against the order and identifiers, you will likely give the wrong drug to the wrong person at some point. The factors involved in such errors can be complex, of course, but remain fairly easy to trace.

Sometimes, though, people just die. We don’t know why, and if we find out, it’s usually not reassuring. The thoughts that follow these deaths—what if I… ?, […]

Not a Nurse but Her Mother Was, and Now It Really Matters

June_Refl_Illustration Illustration by Lisa Dietrich for AJN

The loss of Emily Cappo’s mother, a competent and supportive parent and an accomplished nurse, leaves an enormous gap in her daughter’s life. Then her own son gets sick.

Cappo writes about these events in “I’m Not a Nurse, But My Mother Was,” the Reflections essay in the June issue of AJN.

Without her mother to turn to for help and guidance, Cappo has no idea how she’ll handle the situation. “There I was,” she writes,

the nonmedical person in my family, the person who hated blood and needles, being thrown into a situation demanding courage, stamina, and role modeling.

But we rise to the situation that presents itself, if the stakes are high enough. Cappo discovers what many nurses already know: the nurses who care for her son make all the difference in his care, and provide her with essential support as well. […]

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