About Jacob Molyneux, senior editor/blog editor

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

One Take on the Top 10 Issues Facing Nursing

By Shawn Kennedy, MA, RN, AJN editor-in-chief

So I’ve been in Dallas at the Sigma Theta Tau International (STTI) biennial meeting. The venue is the Gaylord Texan, a large, climate-controlled resort under a glass dome—as you leave your building and walk “outside,” you’re really not. Don’t believe the flowing stream or flowers or gardens (all real) along the walkways, or the Longhorn steer (fake) behind a fence that stands outside my building—you’re still inside. And to make it even more surreal, there are Christmas holiday decorations everywhere, including a gingerbread house the size of a small hotel room. It will be strange to step back in time to Halloween when I get back home.

A daunting list. There are a few thousand people here for the meeting, way too many sessions to choose from (20 different topics for each concurrent session period), plus rows of posters and exhibit booths. And of course, great networking. One lively session I attended was standing room only—and that’s after any floor space had been occupied by people sitting cross-legged. It was a discussion of the top 10 issues facing nursing, led by STTI’s publications director Renee Wilmeth (she’s not a nurse, which probably makes her less biased). The issues were compiled from responses provided by 30 nursing leaders, and were presented in question form:

  1. Is evidence-based practice (EBP) helpful or harmful? (Amazing how many interpretations there were of EBP, some of them—as I know from our […]

Changes in Latitude: Comparing Health Care Systems with Nurses Down Under

By Peggy McDaniel, BSN, RN, who writes the occasional post for this blog and currently works as a clinical liaison support manager of infusion in Australia, New Zealand, and Asia Pacific.

I recently found myself sitting on a boat, enjoying a “sausage sizzle,” dressed as a pirate no less. In Australia, a party that includes barbecued meat usually includes sausage; thus the name. The pirate theme was an added bonus. As an American and a nurse, I was pleasantly surprised to find myself seated at the same table as two Australian nurses. What were the chances of that? The conversation that evening gave me some insight into the Australian health care system, which I am just getting familiar with.

Comparing health care systems. Once we all realized we were experienced nurses and shared the belief that quality patient care should always be the primary focus of health care, the conversation turned to cost. In Australia, there is a public health option that all Australians can access. It is paid for by taxes. If you choose to do so, you can also purchase a private plan to supplement this public option. I have yet to determine what part, if any, employers play in paying for health care or private insurance. However, a sick Australian will […]

The Dance of Empathy

By Peggy McDaniel, BSN, RN. An infusion practice manager currently based overseas, Peggy has written for this blog a number of times in the past.

by Augustin Ruiz, via Flickr

Although it’s only late October, this time of year finds me pondering holidays past, which were often spent working at a hospital. As a younger nurse, I worked in a neuro-trauma-rehab unit at a large children’s hospital. We had a strong primary nursing model and often cared for the same patients throughout their stay, which could last days, weeks, or months. Memories of patients from that unit and others occasionally come back to mind at this time of year, often spurred by holidays.

One of my first assignments was a beautiful youngster who had suffered a brain injury. It was a difficult case and the family spent many hours on our unit, helping me provide basic care and praying for a recovery. But after more than three months, the child’s strong and previously healthy body stopped fighting and the child passed away, with family at the bedside.

Years later, after being away from this facility, I returned for a short stint as a per diem on the float team. I dropped in to work when and where needed, days or nights. Many of the same people I’d loved working with were still there, and […]

Air Force Trauma Nurse: Teacher, Winner of Bronze Star

Air Force nurse Major Kari A. Miller is currently the director of the nurse trauma program and the chief of the critical care nurse program for the U.S. Air Force Center for Sustainment of Trauma and Readiness Skills (C-STARS) in Baltimore, where she helps train military medical personnel who are preparing to deploy, with a focus on teaching trauma assessment, treatment, and skills.

Says Miller: “My C-STARS colleagues and I work directly with the staff of R Adams Cowley Shock Trauma Center [at the University of Maryland], where we see over 8,000 patients per year. The center has an excellent survival rate of 97% and our nurses and physicians are fully integrated with the civilian staff here.”

The photos here show Major Miller and her team during deployment in Ghazni, Afghanistan, in September 2010, when she earned a bronze star for leadership and performance and courage under fire. The team members earned an Army Combat Action Badge for care under fire. The photos on this page show the team treating American casualties received after an improvised explosive device detonated and the vehicle rolled over. Says Miller: “I believe we had three or four casualties with that incident and all had minor injuries. We did fly a couple of them to Bagram for further evaluation and treatment but no fatalities.”—Jacob Molyneux, […]

2016-11-21T13:11:41-05:00October 20th, 2011|Nursing|1 Comment

CMS Proposing New Hospital Regulations—How Will the Changes Affect Your Delivery of Care?

The below information on proposed changes has been shared with AJN by Jeannie Miller, MPH, RN, Deputy Director, Clinical Standards Group, Office of Clinical Standards and Quality (CSG/OCSQ) of the Centers for Medicare and Medicaid Services (CMS).

The Centers for Medicare and Medicaid Services (CMS) has proposed revisions to the hospital Conditions of Participation, the criteria hospitals must meet to be reimbursed for services by Medicare/Medicaid. The changes are needed to remove unnecessary and burdensome regulations that create barriers in care delivery. The changes, if adopted, include:

  • Broadening the concept of “medical staff” to include other practitioners, including APRNs, PAs, and pharmacists, practicing within their scope of practice and in accordance with state law.
  • Changes in nursing care planning to allow for a stand-alone plan or an integrated plan with other disciplines.
  • Allowing medication orders by practitioners other than physicians where the law and hospital policy allows.
  • Allowing a program for patient or “support person” to administer some medications.
  • Calling for standing orders and protocols to be based on nationally recognized and evidence-based guidelines.

There is a 60-day comment period. The CMS would like your comments. The proposed regulation can be found in full via a link on […]

2016-11-21T13:11:42-05:00October 18th, 2011|career|6 Comments
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