About Jacob Molyneux, senior editor/blog editor

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

When There’s a Disconnect Between Good Nursing Practice and Reality

Recently I spoke with other nurses about our personal experiences with hospitalization and those of family members, and the conversation turned to disappointment with nursing practice and nursing care. In fact, whenever I’ve asked, every colleague has disclosed a similar experience. Some say that they’d never leave a family member alone in a hospital.

We need to acknowledge that there is a disconnect between what we know to be good practice and what is often the reality—even in facilities with Magnet accreditation. There are far too many instances in which nursing practice is substandard.

shawnkennedyThis is a heads-up about Shawn Kennedy’s editorial in this month’s issue of AJN, excerpted above. You should read it. The article, “Straight Talk About Nursing,” is free. There are no easy answers to the issues it raises. That’s all the more reason to discuss them openly.

In AJN, we often focus on examples of best practices and insightful, compassionate, engaged care. And we get that there are many institutional obstacles that undermine nurses in their attempts to provide quality care to patients. But even so, we’d be remiss to pretend we don’t hear about, and sometimes personally experience, care that simply falls short. This is scary, at least to me. Patients depend on nurses in so many ways. So have a look at the article and let us know your thoughts, as a nurse or as a patient.—Jacob Molyneux, senior editor

Family Pet Visitation: A Nurse-Led Project at One Illinois Hospital

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We hear a lot about therapy dogs that are specially trained to visit patients in the hospital. But I for one would want to see not just any dog but my own dog, if I were gravely ill and in the hospital. I know I’m not alone, and some nurses set out to determine the pros and cons of making pet visits happen for some patients in their hospital. What safety concerns might there be? According to the current available research, what benefits might patients experience? What protocols would be necessary if it were to happen?

Nurses from Memorial Hospital in Belleville, Illinois, set out to answer these questions and bring such a program to life. They give the details in “Family Pet Visitation,” a feature article in the December issue of AJN (free for a month), along with some moving photos of patients and their pets. Here’s a quote from the start:

[…]

Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the U.S.: An IOM Report

[youtube=http://www.youtube.com/watch?v=CKh78vXIfis&w=640&h=360]
By Natalie McClain, PhD, RN, CPNP, clinical associate professor, William F. Connell School of Nursing, Boston College, and Barbara Guthrie, PhD, RN, FAAN, Independence Foundation Professor of Nursing, Yale University School of Nursing. The above educational video was created by the Institute of Medicine and is available on YouTube.

Each day in the United States, minors experience abuse and violence that is overlooked and unidentified. In some cases, recognition of the abuse makes these minors subject to arrest rather than assistance and care. These children and adolescents are the victims and survivors of commercial sexual exploitation and sex trafficking. A recent report from the Institute of Medicine (IOM) and the National Research Council sheds light on this serious domestic problem and underscores the critical role that nurses must play in preventing, identifying, and responding to these crimes.

Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States is the culmination of a two-year study conducted by an independent panel of experts appointed by the National Academies of Science and funded by the Department of Justice’s Office of Juvenile Justice and Delinquency Prevention. The report states that commercial sexual exploitation and sex trafficking of minors are acts of abuse and violence against children and adolescents. However, the response to these victims is often starkly different from that experienced by other victims of child abuse and neglect. In most states, for example, underage victims of commercial sexual exploitation and sex trafficking can be arrested and prosecuted.

Long-term […]

NP Develops Innovative Runaway Intervention Program in Minnesota

Ten years ago, NP Laurel Edinburgh began to see a number of sexually exploited girls in her practice at the Midwest Children’s Resource Center, a child abuse clinic within Children’s Hospitals and Clinics of Minnesota in St. Paul. The girls, who were runaways, were quickly slipping through the cracks. Half were no longer in school, many hadn’t been reported missing by their parents, and many were staying with gang members. Some had been gang-raped; others had had sex with men in exchange for money or drugs.

Via U.S. Dept. of Health and Human Services Web site Via U.S. Dept. of Health and Human Services Web site

That’s the start of a profile (“Nurse Develops Runaway Intervention Program”) by editor Amy Collins in the November issue of AJN. It’s about a nurse practitioner in Minnesota who, in the course of her daily practice, noticed a population in need and did something about it, finding ways to establish contact with runaway girls and help them rebuild their lives. The article will be free until December 6. The nurse who started the program, Laurel Edinburgh, RN, CNP, hopes her approach will catch on in other states—so please give it a read.—Jacob Molyneux, senior editor

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Are Hospitals Doing Enough to Help Newly Licensed RNs?

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Staff retention is a big issue in hospitals. There can be advantages in hiring newly licensed RNs, but some hospitals and workplaces may pay insufficient attention to helping new nurses with the challenging transition from classroom to clinical practice. In our November issue, some of these issues are brought more clearly to light by an original research article called “Hearing the Voices of Newly Licensed RNs: The Transition to Practice.”

“The first few months of employment is a crucial time in a nurse’s career,” write the authors of this small study. According to interviews with newly licensed RNs conducted by the authors, the following factors can make a big difference:

  • The quality of the preceptor—is the preceptor knowledgeable, adequately experienced, and nonjudgmental?
  • Professional growth and the development of confidence over time in terms of time-management, communication skills, and learning from experience.
  • A sense of being nurtured by the program, the preceptor, and peers.
  • The thoroughness and effectiveness of orientation.

Read the article, or listen to an author podcast on our Web site. What worked in your own transition to practice? What didn’t work? Or how do you help others with this transition? We’d love to know. —Jacob Molyneux, senior editor


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